FOREWORD | 1 · 2017. 9. 12. · FOREWORD | 1 Executive Committee • Adelante • Advocates for...

FOREWORD | 1

Executive Committee • Adelante • Advocates for Basic

Legal Equality • Area Office on Aging of

Northwestern Ohio • Board of Lucas County

Commissioners • City of Toledo • CWA Local 4319 • Connecting Kids to

Meals • Health Partners of

Western Ohio • Hospital Council of

Northwest Ohio • LISC Toledo • Live Well Greater

Toledo • Lucas County

Department of Job & Family Services

• Lucas Metropolitan Housing Authority

• McLaren St. Luke’s • Mental Health &

Recovery Services Board of Lucas County

• Mercy Health • NAACP 3204 • Neighborhood Health

Association • ProMedica • Toledo Fire & Rescue • Toledo/Lucas County

CareNet • Toledo-Lucas County

Health Department • Toledo Lucas County

Homelessness Board • Toledo Public Schools • United Way of Greater

Toledo • University of Toledo

Medical Center • YMCA of Greater Toledo • YWCA of Northwest

Ohio

Formed in 1998, the Healthy Lucas County coalition of community health improvement organizations surveys residents of all ages about their health and well-being every three years. The anonymous surveys ask questions about general physical health, mental health, nutrition, exercise, living conditions and other topics. This report, the 2019/2020 Lucas County Community Health Assessment, details findings from surveys conducted with youth in participating schools in late 2019 and mailed to randomly selected adults and parents of young children in early 2020. The Healthy Lucas County Executive Committee, which governs the coalition, and the assessment’s evaluation team have made every effort to assure this report contains valid and reliable data. Please note, however, that this data is from a snapshot in time. For example, surveys were returned before the COVID-19 pandemic became a public health crisis and had a disproportionate effect on people of color in Lucas County and beyond. The 2019/2020 Lucas County Community Health Assessment measures the health of Lucas County residents on thousands of variables. Data from assessments through the years can be compared to show both areas of improvement and areas that continue to be challenges. This report also compares the health of Lucas County residents to those in the state and nationwide overall. Conducting these health assessments helps Healthy Lucas County Executive Committee members and other organizations determine where to direct efforts to improve the health of Lucas County residents. For example, data from prior surveys have helped coalition members receive millions of dollars in grant funding. This funding has helped women have healthy babies, students get afterschool snacks and meals, adults manage diabetes and heart disease, and numerous other projects. Findings from the 2019/2020 Lucas County Community Health Assessment also will be used by the Healthy Lucas County Executive Committee and its partners to develop the 2021-2024 Lucas County Community Health Improvement Plan. The plan will identify priorities to improve the health of Lucas County residents, outline ways to address disparities in the community, provide action steps to achieve changes that will benefit everyone, and incorporate measurements to determine whether progress is being made. To participate in developing the plan or to learn more, please visit healthylucascounty.org Healthy Lucas County members work toward collective impact, a belief that large-scale social change comes from better cross-sector coordination rather than the isolated interventions of individual organizations. The Healthy Lucas County Executive Committee hopes this assessment will be a valuable tool to assist community-wide efforts to improve the health and well-being of all Lucas County residents.

ACKNOWLEDGEMENTS | 2

Acknowledgements The Healthy Lucas County Executive Committee commissioned this report, which was funded by the following member organizations and the Greater Toledo Community Foundation:

Fostering Healthy Communities (collaboration among Mercy Health, ProMedica and the University of Toledo Medical Center) Toledo-Lucas County Health Department United Way of Greater Toledo Mental Health & Recovery Services Board of Lucas County McLaren St. Luke's Board of Lucas County Commissioners Lucas County Department of Job & Family Services City of Toledo Neighborhood Health Association Health Partners of Western Ohio YMCA of Greater Toledo Toledo-Lucas County Public Library* Area Office on Aging of Northwestern Ohio CWA Local 4319 NAACP #3204 *Member of Healthy Lucas County Executive Committee in 2019. Other Healthy Lucas County Executive Committee member organizations include:

Adelante Advocates for Basic Legal Equality Connecting Kids to Meals Hospital Council of Northwest Ohio LISC Toledo Live Well Greater Toledo Lucas Metropolitan Housing Authority Toledo Fire & Rescue Toledo/Lucas County CareNet Toledo Lucas County Homelessness Board Toledo Public Schools YWCA of Northwest Ohio Contact Information

Julie McKinnon Healthy Lucas County Coordinator Hospital Council of Northwest Ohio 3231 Central Park West Dr., Suite 200 Toledo, OH 43617 (419)-842-0800 [email protected]

mailto:[email protected]

ACKNOWLEDGEMENTS | 3

Project Management, Secondary Data, Data Collection, and Report Development Hospital Council of Northwest Ohio Margaret Wielinski, MPH Interim Director of Community Health Improvement Tessa Elliott, MPH Community Health Improvement Manager Emily Stearns, MPH Community Health Improvement Manager Mallory Ohneck, MPH, CHES Community Health Improvement Data Manager Gabrielle Mackinnon, MPH Community Health Improvement Coordinator Carolynn McCartney Graduate Assistant

Jodi Franks Graduate Assistant Natalie Deeb Graduate Assistant Bailey Fitzgerald Undergraduate Assistant Data Collection & Analysis

Joseph A. Dake, Ph.D., MPH Professor and Chair School of Population Health University of Toledo Aaron J. Kruse-Diehr, Ph.D. Consultant To see Lucas County data compared to other counties, please visit the Hospital Council of Northwest Ohio’s Data Link website at: www.hcno.org/community-services/data-link/

The 2019/2020 Lucas County Health Assessment is available on the following websites:

Healthy Lucas County http://www.healthylucascounty.org/about-us/our-reports/ Hospital Council of Northwest Ohio http://www.hcno.org/community-services/community-health-assessments/ Mental Health and Recovery Services Board of Lucas County https://www.lcmhrsb.oh.gov/resources/ Toledo-Lucas County Health Department https://www.lucascountyhealth.com/reports-data/

http://www.hcno.org/community-services/data-link/

http://www.healthylucascounty.org/about-us/our-reports/

http://www.hcno.org/community-services/community-health-assessments/

https://www.lcmhrsb.oh.gov/resources/

TABLE OF CONTENTS | 4

Table of Contents

EXECUTIVE SUMMARY Page Number

Primary Data Collection Methods 7-9 Secondary Data Collection Methods 10 2019 Ohio State Health Assessment (SHA) 10 Data Summary 11-39 Trend Summary 40-56

HEALTH CARE ACCESS Health Care Coverage 57-59 Access and Utilization 60-62 Preventive Medicine 63-65 Women’s Health 66-67 Men’s Health 68-69 Oral Health 70-71

HEALTH BEHAVIORS Health Status Perceptions 72-74 Adult Weight Status 75-79 Adult Tobacco Use 80-82 Adult Alcohol Consumption 83-85 Adult Drug Use 86-91 Adult Sexual Behavior 92-96 Adult Mental Health 97-100

CHRONIC DISEASE

Cardiovascular Health 101-106 Cancer 107-113 Arthritis 114-115 Asthma 116-118 Diabetes 119-120 Quality of Life 121-122

SOCIAL CONDITIONS Social Determinants of Health 123-131 Environmental Conditions 132

AFRICAN AMERICAN HEALTH CARE ACCESS Health Care Coverage 133-135 Access and Utilization 136-137 Preventive Medicine 138-140 Women’s Health 141-142 Men’s Health 143-144 Oral Health 145-146

AFRICAN AMERICAN HEALTH BEHAVIORS Health Status Perceptions 147-149 Adult Weight Status 150-152 Adult Tobacco Use 153-154 Adult Alcohol Consumption 155-157 Adult Drug Use 158-160 Adult Sexual Behavior 161-163 Adult Mental Health 164-165


AFRICAN AMERICAN CHRONIC DISEASE Cardiovascular Health 166-171 Cancer 172-178 Arthritis 179 Asthma 180-181 Diabetes 182-183 Quality of Life 184-185

AFRICAN AMERICAN SOCIAL CONDITIONS Social Determinants of Health 186-192 Environmental Conditions 193

LATINO HEALTH CARE ACCESS Health Care Coverage 194-196 Access and Utilization 197-199 Preventive Medicine 200-202 Women’s Health 203-204 Men’s Health 205-206 Oral Health 207-208

LATINO HEALTH BEHAVIORS Health Status Perceptions 209-211 Adult Weight Status 212-214 Adult Tobacco Use 215-217 Adult Alcohol Consumption 218-220 Adult Drug Use 221-223 Adult Sexual Behavior 224-226 Adult Mental Health 227-228

LATINO CHRONIC DISEASE

Cardiovascular Health 229-234 Cancer 235-241 Arthritis 242 Asthma 243-244 Diabetes 245-246 Quality of Life 247-248

LATINO SOCIAL CONDITIONS Social Determinants of Health 249-255 Environmental Conditions 256

YOUTH HEALTH Weight Status 257-259 Tobacco Use 260-263 Alcohol Consumption 264-267 Drug Use 268-271 Perceptions of Substance Use 272-274 Sexual Behavior 275-278 Mental Health 279-283 Social Determinants of Health 284-286 Violence 287-290


CHILD HEALTH Child Health and Function Status 291-294 Child Health Care Access 295-299 Early Childhood (Ages 0-5) 300-303 Middle Childhood (Ages 6-11) 304-305 Family and Community Characteristics 306-310 Parent Health 311-312

APPENDICES APPENDIX I Health Assessment Information Sources 313-317 APPENDIX II Acronyms and Terms 318-319 APPENDIX III Weighting Methods 320-322 APPENDIX IV School Participation 323 APPENDIX V Demographic Profile 324-325 APPENDIX VI Demographics and Household Information 326-332 APPENDIX VII 2020 County Health Rankings 333-335

EXECUTIVE SUMMARY | 7

Executive Summary This executive summary provides an overview of health-related data for Lucas County adults (19 years of age and older), youth (ages 12-18), and children (parents of children ages 0-11 completed the survey) who participated in a county-wide health assessment survey from November 2019 through mid-March 2020, before the COVID-19 pandemic became a public health crisis nationwide. The findings are based on self-administered surveys using a structured questionnaire. The questions were modeled after the survey instruments used by the Centers for Disease Control and Prevention (CDC) for their national and state Behavioral Risk Factor Surveillance System (BRFSS) and Youth Risk Behavior Surveillance System (YRBSS), as well as the National Survey of Children’s Health (NSCH) developed by the Child and Adolescent Health Measurement Initiative. The Hospital Council of Northwest Ohio collected the data, guided the health assessment process and integrated sources of primary and secondary data into the final report. Primary Data Collection Methods

DESIGN This community health assessment was cross-sectional in nature and included a written survey of adults, adolescents, and parents of young children within Lucas County. In addition to the general survey mailing, the Healthy Lucas County Executive Committee determined it would be beneficial to oversample the African American and Latino populations. Sections and trend summary tables were created for both populations to identity disparities among the African American and Latino communities. From the beginning, community leaders and members were actively engaged in the planning process and helped define the content, scope, and sequence of the study. Active engagement of community members throughout the planning process is regarded as an important step in completing a valid needs assessment. INSTRUMENT DEVELOPMENT Three survey instruments were designed and pilot tested for this study: one for adults, one for adolescents in grades 6-12, and one for parents of children ages 0-11. As a first step in the design process, health education researchers from The University of Toledo and staff members from The Hospital Council of Northwest Ohio (HCNO) met to discuss potential sources of valid and reliable survey items that would be appropriate to assess the health status and health needs of adults and adolescents. The investigators decided to derive the majority of the adult survey items from the BRFSS. The majority of survey items for the adolescent survey were derived from the YRBSS, and most of the survey items for the parents of children 0-11 were derived from the NSCH. This decision was based on being able to compare local data with state and national data. The project coordinator from The Hospital Council of Northwest Ohio conducted a series of meetings with Healthy Lucas County’s Executive Committee. During these meetings, HCNO and Healthy Lucas County’s Executive Committee reviewed and discussed banks of potential survey questions from the BRFSS, YRBSS and NSCH surveys. Based on input from Healthy Lucas County’s Executive Committee, the project coordinator composed drafts of surveys containing 115 items for the adult survey, 77 items for the adolescent survey, and 82 items for the children’s survey. The drafts were reviewed and approved by health education researchers at The University of Toledo. SAMPLING | Adult Survey The sampling frame for the adult survey consisted of adults ages 19 and older living in Lucas County. There were an estimated 326,715 people ages 19 and older living in Lucas County. The investigators conducted a power analysis to determine what sample size was needed to ensure a 95% confidence level with a corresponding margin of error of 5% (i.e., we can be 95% sure that the “true” population responses are within a 5% margin of error of the survey findings). A sample size of at least 384 adults was needed to ensure this level of confidence for the general population. The investigators also calculated the population of African American and Latino adults living in Lucas County. According to 2015 American Community Survey 5-year estimates, approximately 59,373 African American and 16,961 Latino adults 19 years and older were living in Lucas County. A sample size of at least 382 African American adults and 376 Latino adults were needed to ensure a 95% confidence level for each population.


The random sample of mailing addresses of adults from Lucas County was obtained from Melissa Data Corporation in Rancho Santa Margarita, California. Surveys were mailed in early February 2020 and returned through mid-March 2020. SAMPLING | Adolescent Survey The sampling frame for the adolescent survey consisted of youth in grades 6-12 in Lucas County public school districts. For more information on participating districts and schools, see Appendix IV. The U.S. 2010 Census Bureau reported that approximately 43,198 of youth ages 12-18 years old live in Lucas County. A sample size of 382 adolescents was needed to ensure a 95% confidence interval with a corresponding 5% margin of error (i.e., we can be 95% sure that the “true” population responses are within a 5% margin of error of the survey findings). Students were randomly selected and surveyed in the schools in November and December 2019. SAMPLING | 0-11 Survey The sampling frame for the survey of children consisted of parents of children ages 0-11 in Lucas County. The U.S. 2010 Census Bureau determined that approximately 69,902 children ages 0-11 live in Lucas County. The investigators conducted a power analysis based on a post-hoc distribution of variation in responses (70/30 split) to determine what sample size was needed to ensure a 95% confidence level with corresponding confidence interval of 5% (i.e., we can be 95% sure that the “true” population responses are within a 5% margin of error). The sample size required to generalize to children ages 0-11 was 382. The random sample of mailing addresses of parents of children 0-11 was obtained from Melissa Data Corporation in Rancho Santa Margarita, California. Surveys were mailed in early February 2020 and returned through mid-March 2020. PROCEDURE | Adult Survey Prior to mailing the survey, the project coordinator mailed an advance letter to 6,800 adults in Lucas County: 2,000 to the general population, 2,400 to the African American population, and 2,400 to the Latino population. This advance letter was printed on Healthy Lucas County Executive Committee stationery and signed on behalf of the group by Executive Committee Chair Sister Dorothy Thum of Mercy Health and Executive Committee Chair Erika. D. White of CWA Local 4319 and NAACP 3204. The letter introduced the county health assessment project and informed readers that they may be randomly selected to receive the survey. The letter also explained that the respondents’ confidentiality would be protected, and it encouraged the readers to complete and return the survey promptly if they were selected. Three weeks following the advance letter, a mailing procedure was implemented to maximize the survey return rate. The mailing included a personalized, hand signed cover letter (on Healthy Lucas County Executive Committee stationery) describing the purpose of the study, the questionnaire, a self-addressed stamped return envelope, and a $2 incentive, which were all included in a large green envelope. Surveys returned as undeliverable were not replaced with another potential respondent. The response rate for the general population was 10% (n=698: CI=± 3.71). This return rate and sample size means that the responses in the health assessment should be representative of the entire county. There were a total of 146 African American respondents (n=146: CI= ± 8.1) and 114 Latino respondents (n=114: CI= ± 9.1). As a result, there is a greater margin of error when generalizing to the overall population of these specific two racial/ethnic groups. Caution should be taken when generalizing the results of this assessment to the African American and Latino communities.

Note: “n” refers to the total sample size, “CI” refers to the confidence internal. PROCEDURE | Adolescent Survey The survey was approved by all participating superintendents. Schools and grades were randomly selected. Each student in a particular grade had to have an equal chance of being in the class that was selected, such as a home room or health class. Classrooms were randomly chosen by the school principal. Passive permission slips were mailed home to parents of any student whose class was selected to participate. The response rate was 91% (n=1,033: CI=± 3.01). This return rate and sample size means that the responses in the health assessment should be representative of the entire county.

Note: “n” refers to the total sample size, “CI” refers to the confidence internal.


PROCEDURE | Children 0-5 and 6-11 Prior to mailing the survey to parents of children ages 0-11, the project team mailed an advance letter to 5,000 parents in Lucas County. This advance letter was printed on Healthy Lucas County Executive Committee stationery and signed on behalf of the group by Executive Committee Chair, Sister Dorothy Thum of Mercy Health and Executive Committee Chair Erika D. White of CWA Local 4319 and NAACP 3204. The letter introduced the county health assessment project and informed readers that they may be randomly selected to receive the survey. The letter also explained that the respondents’ confidentiality would be protected and encouraged the readers to complete and return the survey promptly if they were selected. Three weeks following the advance letter, a mailing procedure was implemented to maximize the survey return rate. The mailing included a personalized, hand-signed cover letter (on Healthy Lucas County Executive Committee stationery) describing the purpose of the study, a questionnaire, a self-addressed stamped return envelope, and a $2 incentive. Surveys returned as undeliverable were not replaced with another potential respondent. The response rate was 6% (n=304: CI=± 5.61).

Note: “n” refers to the total sample size, “CI” refers to the confidence internal. DATA ANALYSIS Individual responses were anonymous. Only group data was available. All data was analyzed by health education researchers at the University of Toledo using Statistical Product and Service Solutions 26.0 (SPSS). Crosstabs were used to calculate descriptive statistics for the data presented in this report. To be representative of Lucas County, the adult data collected was weighted by age, gender, race, and income using Census data (Note: income data throughout the report represents annual household income). Multiple weightings were created based on this information to account for different types of analyses. Additionally, due to variation in the sizes of the classes selected as well as to some districts which sampled additional general education classes, it was determined that applying a weighting during analyses would be important. For more information on how the adult weightings were created and applied, see Appendix III. LIMITATIONS As with all county health assessments, it is important to consider the findings with respect to all possible limitations. First, the Lucas County adult assessment had a high response rate. However, if any important differences existed between the respondents and the non-respondents regarding the questions asked, this would represent a threat to the external validity of the results (the generalizability of the results to the population of Lucas County). If there were little to no differences between respondents and non-respondents, then this would not be a limitation. Second, the response rate for African Americans and Latinos in Lucas County was very low, even though a specialized mailing list was purchased to recruit African Americans and Latinos. To be 95% confident in our findings with a 5% margin of error, we would have needed 382 surveys to be returned from the African American population and 376 from the Latino population. Response rates for both populations were low, yielding only 146 African American responses and 114 Latino responses and resulting in margins of error of 8.1% and 9.1%, respectively. Additionally, the child data did not include enough African American or Latino responses to break the data down into a child-specific minority trend summary table. Furthermore, while the minority adult surveys were sent to random households in Lucas County, those responding to the survey were more likely to be older. While weightings were applied during calculations to help account for this, it still presents a potential limitation (to the extent that the responses from these individuals might be substantively different than the majority of Lucas County minority residents younger than 30). Therefore, those younger than 30 were not included in the African American or Latino graphs throughout the report. Additionally, the African American and Latino trend summary and comparison tables reflect 2018 state and national Behavioral Risk Factor Surveillance System (BRFSS) comparison data. 2019 comparison data was not yet available as of November 2020 via the Center for Disease Control and Prevention’s (CDC) Web Enabled Analysis Tool (WEAT), which allows custom crosstabulation tables for health indicators to be viewed by race and ethnicity.


It is important to note that, although several questions were asked using the same wording as the CDC questionnaires and the NSCH questionnaire, the adult and parent data collection method differed. CDC adult data and NSCH child data were collected using a set of questions from the total question bank and adults were asked the questions over the telephone rather than via mail survey. The youth CDC survey was administered in schools in a similar fashion as this county health assessment. Lastly, this survey asked parents questions regarding their young children. Should enough parents have felt compelled to give incorrect information about their child’s health for a favorable response, this would represent a threat to the internal validity of the results. Secondary Data Collection Methods HCNO collected secondary data, including county-level data, from multiple sources whenever possible. HCNO utilized sources such as the Behavioral Risk Factor Surveillance System (BRFSS), numerous CDC webpages, U.S. Census data, Healthy People 2020, and other national and local sources. All primary data in this report is from the 2019/2020 Lucas County Community Health Assessment (CHA). All other data is cited accordingly. 2019 Ohio State Health Assessment (SHA) The 2019 Ohio State Health Assessment (SHA) provides data needed to inform health improvement priorities and strategies in the state. This assessment includes over 140 metrics, organized into data profiles, as well as information gathered through five regional forums, online surveys completed by over 300 stakeholders, and advisory and steering committee members who represented 13 state agencies, including sectors beyond health.

Similar to the 2019 Ohio SHA, the 2019/2020 Lucas County Community Health Assessment (CHA) examined a variety of metrics from various areas of health including, but not limited to, health behaviors, chronic disease, access to health care, and social determinants of health. Additionally, the CHA studied themes and perceptions from local public health stakeholders from a wide variety of sectors. Note: This symbol will be displayed in the trend summary when an indicator directly aligns with the 2019 Ohio SHA.

The interconnectedness of Ohio’s greatest health challenges, along with the overall consistency of health priorities identified in this assessment, indicates many opportunities for collaboration among a wide variety of partners at and between the state and local level, including physical and behavioral health organizations and sectors beyond health. It is Healthy Lucas County’s hope that this CHA will serve as a foundation for such collaboration.

To view the full 2019 Ohio State Health Assessment, please visit: https://odh.ohio.gov/wps/portal/gov/odh/about-us/sha-ship/

FIGURE 1.1 | Components of the 2019 State Health Assessment (SHA)

https://odh.ohio.gov/wps/portal/gov/odh/about-us/sha-ship/

https://odh.ohio.gov/wps/portal/gov/odh/about-us/sha-ship/

DATA SUMMARY | 11

8%6%

11%

20%

8%

1%

11%

8%

5%

11% 10%

13% 14%

6%

0%

10%

20%

30%

Lucas2020

Males Females 30 Years& Under

30-64Years

65 &Over

Income<$25K

Income$25KPlus

White AfricanAmerican

Latino Lucas2011

Lucas2014

Lucas2017

Uninsured Lucas County Adults

Data Summary | Health Care Access HEALTH CARE COVERAGE In 2020, 8% of Lucas County adults were without health care coverage. Those most likely to be uninsured were adults under the age of 30 (20%) and those with annual income levels under $25,000 (11%). The top reason adults reported for being without health care coverage was cost (37%). ACCESS AND UTILIZATION Eleven percent (11%) of adults went outside of Lucas County for health care services in the past year. Twenty percent (20%) of adults looked for a program to help with depression, anxiety, or some mental health problem. PREVENTIVE MEDICINE More than half (57%) of Lucas County adults had a flu vaccine during the past year. Nearly three-fourths (73%) of adults ages 65 and older had a pneumonia vaccination at some time in their life.

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

57% 55% 57%

48%53%

77%

64%56% 56% 55%

65%

37%

53% 52%

0%

20%

40%

60%

80%

100%

Lucas2020

Male Female 30 Years& Under

30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults who Received a Flu Vaccine Within the Past Year

DATA SUMMARY | 12

WOMEN’S HEALTH In 2020, over half (58%) of Lucas County women over the age of 40 reported having a mammogram. In the past year, 55% of Lucas County women had a clinical breast exam, and 35% had a Pap smear to detect cancer of the cervix. More than one-third (39%) were obese, 34% had high blood pressure, 27% had high blood cholesterol, and 16% were identified as current smokers, all known risk factors for cardiovascular diseases.

MEN’S HEALTH More than half (58%) of Lucas County men had a digital rectal exam in their lifetime, and 17% had one in the past year. More than two-fifths (44%) of men had been diagnosed with high blood pressure, 27% had high blood cholesterol, and 14% were identified as smokers, which, along with obesity (36%), are known risk factors for cardiovascular diseases. ORAL HEALTH Sixty-four percent (64%) of Lucas County adults visited a dentist or dental clinic in the past year. One-fifth (20%) of adults did not see a dentist in the past year due to cost.


40%

15%

58%

37%42%

37%

48%

53%

42%

36%

55%

61%

51%

43%

61%

52%

61% 60%55% 57%

36%

46%

29%

21%

44%

33%

44%

54%49%

41%

0%

25%

50%

75%

100%

Lucas 2020 Under 40 40 & Older Income<$25K

Income$25K Plus


Latino Lucas 2014 Lucas 2017

Lucas County Women's Health Exams Within the Past Year

Mammogram Breast Exam Pap Smear

64% 65% 63% 61%66%

61%

39%

72% 71%

44%

58%

68% 66% 66%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25KPlus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Visiting a Dentist or Dental Clinic in the Past Year

DATA SUMMARY | 13

45% 47% 45% 43% 49%36%

20%

55% 50%36%

45% 48% 45% 49%

38% 39% 37%50% 34%

38%

46%

35%37%

39%

40% 34% 37%37%

17% 14% 18%7%

17%26%

34%

10% 13%25%

15% 18% 18% 14%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Health Perceptions*

Excellent/Very Good Good Fair/Poor

Data Summary | Health Behaviors HEALTH STATUS PERCEPTIONS In 2020, 45% of Lucas County adults rated their health status as excellent or very good. Conversely, 17% of adults described their health as fair or poor, increasing to 34% of those with annual incomes less than $25,000.

*Respondents were asked: “Would you say that in general your health is excellent, very good, good, fair or poor?” ADULT WEIGHT STATUS Nearly three-fourths (72%) of Lucas County adults were overweight (34%) or obese (38%) based on body mass index (BMI). One-fourth (25%) of adults did not participate in any physical activity in the past week, including 3% who were unable to exercise.

*Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight. Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that

of the overall survey.

27% 22%31%

38%24% 22% 21%

28% 32%21% 17%

28% 29% 25%

34% 41% 28%

31%

36% 38% 34%33%

34%

34%29%

36% 34% 38%

38% 36% 39% 24% 39% 39% 43%38% 32%

45%51%

35% 36% 36%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult BMI Classifications*

Normal Overweight Obese

DATA SUMMARY | 14

ADULT TOBACCO USE In 2020, 15% of Lucas County adults were current smokers, and 25% were considered former smokers. Four percent (4%) of adults used e-cigarettes or vapes in the past year. Seventy-six percent (76%) of adults reported they would support an ordinance to ban smoking in a vehicle with a minor present.

*Respondents were asked: “Have you smoked at least 100 cigarettes in your entire life? If yes, do you now smoke cigarettes every day, some days or not at all?”

ADULT ALCOHOL USE Sixty percent (60%) of Lucas County adults had at least one alcoholic drink in the past month. Twenty-two percent (22%) of adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on one occasion in the last month and would be considered binge drinkers.


3.5

4.3

2.8

3.83.3

3.84.2

3.4 3.3

4.14.4

3.0

4.0

2.8

0

2

4

6

8

10

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Adults' Average Number of Drinks Consumed Per Drinking Occasion

15% 14% 16%10%

16%10%

27%

11% 16% 21%14%

24% 19% 14%

25% 25% 25%

10%

27% 39%

26%

26%26% 18% 30%

23%25%

23%

60% 61% 59%

80%

57%51% 47%

63% 58% 61% 56% 53% 56%63%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Smoking Behaviors*

Current smoker Former smoker Never smoked

DATA SUMMARY | 15

ADULT DRUG USE In 2020, 16% of Lucas County adults reported they and/or an immediate family member or someone in their household used recreational marijuana during the past 6 months. Eight percent (8%) of adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past 6 months.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

ADULT SEXUAL BEHAVIOR Sixty-three percent (63%) of Lucas County adults had sexual intercourse in the past year. Seven percent (7%) of adults had more than one partner. Nine percent (9%) of Lucas County adults were forced to have any sort of unwanted sexual activity, increasing to 13% of females and 16% of those with annual incomes less than $25,000. ADULT MENTAL HEALTH Five percent (5%) of Lucas County adults considered attempting suicide in the past year. During the past year, 24% of adults had a period of two or more weeks when they felt sad, blue or depressed.

7% 7%8%

17%

6%

2%

6%8% 8%

6%7%

11%10%

12%

0%

5%

10%

15%

20%

25%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Recreational Marijuana Use in Past 6 Months

DATA SUMMARY | 16

Data Summary | Chronic Disease

CARDIOVASCULAR HEALTH Four percent (4%) of adults had survived a heart attack and 3% had survived a stroke at some time in their life. Thirty-nine percent (39%) had high blood pressure, 38% were obese, 27% had high blood cholesterol, and 15% were current smokers, which are four known risk factors for heart disease and stroke. CANCER In 2020, 12% of Lucas County adults had been diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (2,980) of all (14,042) Lucas County resident deaths. ARTHRITIS Eighteen percent (18%) of Lucas County adults were diagnosed with arthritis. ASTHMA In 2020, 13% of Lucas County adults were diagnosed with asthma.


13%10%

15%

37%39%

10%13% 12% 11%

19%

13% 13% 13%10%

0%

10%

20%

30%

40%

50%

Lucas2020

Males Females 30 &Younger

30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with Asthma

39% 38%

25%

15%13%

0%

25%

50%

High Blood Pressure Obesity Sedentary Smoking Diabetes

Lucas County Adults with Cardiovascular Disease Risk Factors

DATA SUMMARY | 17

DIABETES In 2020, 13% of Lucas County residents reported they had been diagnosed with diabetes at some time in their lifetime. More than one-third (37%) of adults with diabetes rated their health as fair or poor. QUALITY OF LIFE In 2020, 37% of Lucas County adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were back or neck problems (44%); arthritis/rheumatism (38%); stress, depression, anxiety and emotional problems (32%); chronic pain (25%); and sleep problems (22%).


13% 14%12%

0%

14%

26% 26%

10% 11%

15% 13% 13%15%

12%

0%

10%

20%

30%

40%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with Diabetes

37%32%

42%

31%

38%44%

60%

29%32%

50%

39%

47%43%

0%

25%

50%

75%

Lucas2020

Male Female 30 &Younger

30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2014

Lucas2017

Lucas County Adults Limited in Some Way

DATA SUMMARY | 18

Data Summary | Social Conditions

SOCIAL DETERMINANTS OF HEALTH In 2020, 8% of Lucas County adults had to choose between paying bills and buying food. Fifteen percent (15%) of adults experienced four or more adverse childhood experiences (ACEs) in their lifetime (ACEs are stressful or traumatic events, for example, parents becoming separated or divorced, or living with someone who was a problem drinker or alcoholic).

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey. ENVIRONMENTAL HEALTH Lucas County adults reported the following as the top four issues that threatened their health in the past year: bed bugs (8%), mold (8%), insects (7%), and rodents (6%). Ten percent (10%) of adults reported they had a disaster plan in preparation of a disaster.

15%12%

18%

30%

14%

8%

20%

13% 12%

18%

27%

0%

10%

20%

30%

40%

Lucas 2020 Male Female 30 Yearsand Under

30-64Years

65 & Over Income<$25K

Income$25K Plus


Latino

Lucas County Adults Who Experienced Four or More ACEs

DATA SUMMARY | 19

African American Data Summary | Health Care Access AFRICAN AMERICAN HEALTH CARE COVERAGE In 2020, 11% of Lucas County African American adults were without health care coverage. Those most likely to be uninsured were females (13%) and those with annual incomes less than $25,000 (10%). AFRICAN AMERICAN ACCESS AND UTILIZATION One-fifth (20%) of Lucas County African American adults did not get their prescriptions from their doctor filled in the past year. Twenty-one percent (21%) of African American adults looked for a program to help with depression, anxiety, or some mental health problem. AFRICAN AMERICAN PREVENTIVE MEDICINE More than half (55%) of Lucas County African American adults had a flu vaccine during the past year. More than two-thirds (70%) of African American adults ages 65 and older had a pneumonia vaccine at some time in their life.

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that


55%

46%

59%

50%

76%

66%

50%

28%

40%

59%

0%

20%

40%

60%

80%

100%

Lucas AfricanAmerican

2020

Male Female 30-64 Years 65 & Over Income<$25K

Income $25KPlus


2011


2014


2017

Lucas County African American Adults who Received a Flu Vaccine Within the Past Year

11%

8%

13%

8%

2%

10%

6%

25% 25%

3%

0%

10%

20%

30%

LucasAfrican

American2020

Males Females 30-64 Years 65 & Over Income<$25K

Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Who Were Uninsured

DATA SUMMARY | 20

AFRICAN AMERICAN WOMEN’S HEALTH In 2020, over half (55%) of Lucas County African American women older than age 40 reported having a mammogram. Sixty-one percent (61%) of Lucas County African American women had a clinical breast exam, and 44% had a Pap smear to detect cancer of the cervix, in the past year. More than half (53%) had high blood pressure, 44% were obese, 30% had high blood cholesterol, and 22% were identified as current smokers, which are known risk factors for cardiovascular diseases. AFRICAN AMERICAN MEN’S HEALTH More than three fourths (76%) of Lucas County African American men had a digital rectal exam in their lifetime, and 22% had one in the past year. More than half (57%) of African American men had been diagnosed with high blood pressure, 31% had high blood cholesterol, and 18% were identified as smokers, which, along with obesity (43%), are known risk factors for cardiovascular diseases. AFRICAN AMERICAN ORAL HEALTH Forty-four percent (44%) of Lucas County African American adults visited a dentist or dental clinic in the past year. Eleven percent (11%) of African American adults did not see a dentist in the past year due to cost.


44%40%

47%51%

35%

26%

60% 60%

51%

63%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Who Visited a Dentist or Dental Clinic in the Past Year

48%

38%

55%

42%

57%49% 49%

61%

88%

48% 50%

71%

53%60%

44%

75%

24%32%

54%

42%50%

0%

20%

40%

60%

80%

100%

Lucas AfricanAmerican 2020

Under 40 40 & Older Income <$25K Income >$25K Lucas AfricanAmerican 2014


Lucas County African American Women's Health Exams Within the Past Year


DATA SUMMARY | 21

African American Data Summary | Health Behaviors AFRICAN AMERICAN HEALTH STATUS PERCEPTIONS In 2020, 36% of Lucas County African American adults rated their health status as excellent or very good. Conversely, 25% of African American adults described their health as fair or poor, increasing to 33% of those with annual incomes less than $25,000. AFRICAN AMERICAN ADULT WEIGHT STATUS Nearly four-fifths (79%) of Lucas County African American adults were overweight or obese based on body mass index (BMI). Twenty-nine percent (29%) of African American adults did not participate in any physical activity in the past week, including 2% who were unable to exercise.

*Note: Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight.


AFRICAN AMERICAN ADULT TOBACCO USE In 2020, 21% of Lucas County African American adults were current smokers, and 18% were considered former smokers. Three percent (3%) of African American adults used e-cigarettes or vapes in the past year.

21% 25%18% 13% 17% 13%

23% 24% 23%14%

34% 32%38%

32%32%

31%

30% 28% 35%

27%

45% 43% 44%55% 51% 56%

47% 47% 39%58%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020

Male Female 30-64 Years 65 & Over Income <$25K

Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adult BMI Classifications*


DATA SUMMARY | 22

AFRICAN AMERICAN ADULT ALCOHOL CONSUMPTION Nearly half (46%) of Lucas County African American adults had at least one alcoholic drink in the past month. One-fifth (20%) of African American adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers.

*Percentages may not equal 100% as some respondents answered “don’t know.”

AFRICAN AMERICAN ADULT DRUG USE

In 2020, 11% of Lucas County African American adults had used recreational marijuana during the past 6 months. Nine percent (9%) of African American adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past 6 months.


9%10%

9%

11%

4%

15%

8% 8%

11% 11%

0%

5%

10%

15%

20%


2020


Income$25K Plus


2011


2014


2017

Lucas County African American Adult Medication Misuse in the Past 6 Months

51% 57%47% 51%

60% 57%

40%

57%45%

58%

15%13%

17%18%

10% 18%

16%

14%19%

21%

31% 28% 32% 27% 25% 21%

43%29% 27%

21%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Average Number of Days Drinking Alcohol in the Past Month*

Did not drink any 1-2 days 3 or more days

DATA SUMMARY | 23

AFRICAN AMERICAN ADULT SEXUAL BEHAVIOR In 2020, 57% of Lucas County African American adults had sexual intercourse. Six percent (6%) of African American adults had more than one partner.

*Respondents were asked: “During the past 12 months, with how many different people have you had sexual intercourse?” Note: Percentages may not equal 100% as some respondents answered “don’t know”


AFRICAN AMERICAN ADULT MENTAL HEALTH Nine percent (9%) of Lucas County African American adults seriously considered attempting suicide in the past year. During the past year, 23% of African American adults had a period of two or more weeks when they felt sad, blue or depressed.

51% 49%

38%

63%

31%

44%61%

46%54%

39%

6%4%

7%

4%

4%

4%

10%

20%17%

26%

34% 27%

38%

30%

58%

40%

29%34%

29%31%

0%

20%

40%

60%

80%

100%


2020


Income $25KPlus


2011


2014


2017

Lucas County African American Adult Number of Sexual Partners in the Past Year*

One More than one None

DATA SUMMARY | 24

African American Data Summary | Chronic Disease AFRICAN AMERICAN CARDIOVASCULAR HEALTH

Five percent (5%) of Lucas County African American adults had survived a heart attack and 4% had survived a stroke at some time in their life. Fifty-five percent (55%) of African American adults had high blood pressure, 45% were obese, 31% had high blood cholesterol, and 21% were current smokers, which are four known risk factors for heart disease and stroke.

AFRICAN AMERICAN CANCER In 2020, 11% of Lucas County African American adults were diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (533) of all (2,543) Lucas County African American resident deaths. AFRICAN AMERICAN ARTHRITIS Twenty-three percent (23%) of Lucas County African American adults were diagnosed with arthritis. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

23% 22%25% 23%

46%

39%

14%

22%18%

22%

0%

10%

20%

30%

40%

50%

60%

LucasAfrican

American2020


Income $25KPlus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with Arthritis

55%

45%

29%

21%15%

0%

20%

40%

60%

80%


Lucas County African American Adults with Cardiovascular Disease Risk Factors

DATA SUMMARY | 25

AFRICAN AMERICAN ASTHMA In 2020, 19% of Lucas County African American adults were diagnosed with asthma. AFRICAN AMERICAN DIABETES In 2020, 15% of Lucas County African American adults were diagnosed with diabetes at some point in their lifetme. Thirty-eight percent (38%) of African American adults with diabetes rated their health as fair or poor. AFRICAN AMERICAN QUALITY OF LIFE

In 2020, 45% of Lucas County African American adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were arthritis/rheumatism (48%); back or neck problems (42%); stress, depression, anxiety and emotional problems (32%); vision problems (31%); and chronic pain (25%).

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

19%16%

23%

15%12%

10%

27%

14% 15% 14%

0%

10%

20%

30%

40%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with Asthma

48%42%

32% 31%25%

0%

20%

40%

60%

80%

Arthritis/Rheumatism Back/Neck Problems Stress, Depression,Anxiety, or Emotional

Problems

Eye/Vision problems Chronic Pain

Lucas County African American Adult's Most Limiting Health Problems

DATA SUMMARY | 26

African American Data Summary | Social Conditions AFRICAN AMERICAN SOCIAL DETERMINANTS OF HEALTH In 2020, 19% of Lucas County African American adults had to choose between paying bills and buying food. Eighteen percent (18%) of adults experienced four or more adverse childhood experiences (ACEs) in their lifetime (ACEs are stressful or traumatic events, for example, parents becoming separated or divorced, or living with someone who was a problem drinker or alcoholic).


AFRICAN AMERICAN ENVIRONMENTAL HEALTH

Lucas County African American adults reported the following as the top four issues that threatened their health in the past year: mold (8%), bed bugs (8%), insects (7%), and rodents (6%). Eight percent (8%) of African American adults reported they had a disaster plan in preparation of a disaster.

18%20%

15% 16%

4%

17%

14%

0%

10%

20%

30%


Male Female 30-64 Years 65 & Over Income <$25K Income $25KPlus

Lucas County African American Adults Who Experienced Four or More ACEs

DATA SUMMARY | 27

Latino Data Summary | Health Care Access LATINO HEALTH CARE COVERAGE Ten percent (10%) of Lucas County Latino adults were without health care coverage in 2020. Those most likely to be uninsured were females (15%) and those with an annual income level of $25,000 or more (11%). LATINO ACCESS AND UTILIZATION Ten percent (10%) of Lucas County Latino adults went outside of Lucas County for health care services in the past year. Twenty-one percent (21%) of Latino adults looked for a program to help with depression, anxiety, or some mental health problem. LATINO PREVENTIVE MEDICINE Sixty-five percent (65%) of Lucas County Latino adults had a flu vaccine during the past year. Seventy percent (70%) of Latino adults ages 65 and older had a pneumonia vaccine at some time in their life. Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

10%

6%

15%

10%

3%

9%11%

17%19%

10%

0%

10%

20%

30%

Lucas Latino2020


Income$25Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Who Were Uninsured

65% 66%62% 61%

87%

69%65%

37%

52%

40%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults who Received a Flu Vaccine Within the Past Year

DATA SUMMARY | 28

LATINA WOMEN’S HEALTH In 2020, 69% of Lucas County Latina women older than the age of 40 reported having a mammogram. Sixty percent (60%) of Lucas County Latina women had a clinical breast exam, and 54% had a Pap smear to detect cancer of the cervix, in the past year. More than half (56%) were obese, 27% had high blood pressure,18% had high blood cholesterol, and 14% were identified as current smokers, which are known risk factors for cardiovascular diseases. LATINO MEN’S HEALTH Forty-two percent (42%) of Lucas County Latino men had a digital rectal exam in their lifetime, and 5% had one in the past year. More than one-third (35%) of Latino men had been diagnosed with high blood pressure, 23% had high blood cholesterol, and 15% were identified as smokers, which, along with obesity (48%), are known risk factors for cardiovascular diseases. LATINO ORAL HEALTH Fifty-eight percent (58%) of Lucas County Latino adults visited a dentist or dental clinic in the past year. Seventeen percent (17%) of Latino adults did not see a dentist in the past year due to cost.


53%

33%

69%

50% 53%

27% 27%

60%67% 67% 67%

60%

4%

54%54%

67%

44% 43%

53%61%

48%

0%

25%

50%

75%

100%

Lucas Latino2020

Under 40 40 & Older Income <$25K Income >$25K Lucas Latino2014

Lucas Latino2017

Lucas County Latina Women's Health Exams Within the Past Year


58% 57% 60% 62%57%

49%

65%

56%61%

39%

0%

20%

40%

60%

80%

100%

LucasLatino 2020


Income$25K Plus

LucasLatino 2011

LucasLatino 2014

LucasLatino 2017

Lucas County Latino Adults Visiting a Dentist or Dental Clinic in the Past Year

DATA SUMMARY | 29

Latino Data Summary | Health Behaviors LATINO HEALTH STATUS PERCEPTIONS

In 2020, 45% of Lucas County Latino adults rated their health status as excellent or very good. Conversely,15% of Latino adults described their health as fair or poor, increasing to 27% of those with annual incomes less than $25,000. LATINO ADULT WEIGHT STATUS Eighty percent (80%) of Lucas County Latino adults were overweight or obese based on body mass index (BMI). Twenty-nine percent (29%) of Latino adults did not participate in any physical activity in the past week, including 1% who were unable to exercise.

*Note: Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey.

LATINO ADULT TOBACCO USE

In 2020, 14% of Lucas County Latino adults were current smokers, and 30% were considered former smokers. One-fourth (25%) of Latino adults used cigarettes in the past year. Forty-two percent (42%) of Latino current smokers responded that they had stopped smoking for at least one day in the past year because they were trying to quit smoking.

17%9%

26%13% 20% 18% 19% 21% 21% 20%

29% 38%19%

29%

52%

21%31%

37% 30% 38%

51% 48% 56% 57%

28%

62% 47%42% 49% 42%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult BMI Classifications*


DATA SUMMARY | 30

LATINO ADULT ALCOHOL CONSUMPTION More than half (53%) of Lucas County Latino adults had at least one alcoholic drink in the past month. More than one-third (37%) of Latino adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers.

*Percentages may not equal 100% as some respondents answered “don’t know”

LATINO ADULT DRUG USE

Seven percent (7%) of Lucas County Latino adults had used recreational marijuana during the past 6 months. Six percent (6%) of Latino adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past 6 months.


45%36%

56%44% 40%

71%

36%43% 44%

10%

4%

18%

15%

4%

3%

12%

25%14%

43%59%

24%38%

56%

26%

52%

32%37%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Lucas Latino2011

Lucas Latino2014

Lucas County Latino Adults Average Number of Days Drinking Alcohol in the Past Month*


7%

9%

5%

11%

4%

6%7%

10%11%

9%

0%

5%

10%

15%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Marijuana Use in the Past 6 Months

DATA SUMMARY | 31

LATINO ADULT SEXUAL BEHAVIOR Seventy-five percent (75%) of Lucas County Latino adults had sexual intercourse in the past year. Ten percent (10%) of Latino adults had more than one partner.

*Percentages may not equal 100% as some respondents answered “don’t know.” Note: Respondents were asked: “During the past 12 months, with how many different people have you had sexual intercourse?” Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey. LATINO ADULT MENTAL HEALTH Four percent (4%) of Lucas County Latino adults considered attempting suicide in the past year. During the past year, 29% of Latino adults had a period of two or more weeks when they felt sad, blue or depressed.

65% 67% 61%73%

33%43%

74% 69% 67%

10% 8%13%

8%

4%

9%

9%10% 9%

24% 24% 25% 18%

59%49%

16% 21% 24%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Lucas Latino2011

Lucas Latino2014

Lucas County Latino Number of Sexual Partners in the Past Year*


DATA SUMMARY | 32

Latino Data Summary | Chronic Disease LATINO CARDIOVASCULAR HEALTH Six percent (6%) of Lucas County Latino adults had survived a heart attack and 5% had survived a stroke at some time in their life. Fifty-one percent (51%) of adults were obese, 32% had high blood pressure, 21% had high blood cholesterol, and 14% were current smokers, all four of which are known risk factors for heart disease and stroke.

LATINO CANCER

In 2020, 7% of Lucas County Latino adults were diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 16% (54) of all (328) Lucas County Latino resident deaths. LATINO ARTHRITIS Eleven percent (11%) of Lucas County Latino adults were diagnosed with some form of arthritis.

32%

51%

29%

14% 13%

0%

20%

40%

60%


Lucas County Latino Adults with Cardiovascular Disease Risk Factors

DATA SUMMARY | 33

LATINO ASTHMA In 2020, 13% of Lucas County Latino adults were diagnosed with asthma.


LATINO DIABETES

In 2020, 13% of Lucas County Latino adults were diagnosed with diabetes at some point in their lifetime. Forty-one percent (41%) of Latino adults with diabetes rated their health as fair or poor. LATINO QUALITY OF LIFE In 2020, 35% of Lucas County Latino adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were back or neck problems (41%); stress, depression, anxiety or emotional problems (33%); sleep problems (31%); eye/vision problems (24%); and walking problems (22%).

13%15%

11%12%

0%

11% 11%13%

15%

7%

0%

5%

10%

15%

20%

25%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Diagnosed with Asthma

41%33% 31%

24% 22%

0%

20%

40%

60%

80%

100%

Back/Neck Problems Stress, Depression,Anxiety, or Emotional

Problems

Sleep Problems Eye/Vision Problems Walking Problems

Lucas County Latino Adults Most Limiting Health Problems

DATA SUMMARY | 34

Latino Data Summary | Social Conditions LATINO SOCIAL DETERMINANTS OF HEALTH

In 2020, 5% of Lucas County Latino adults had to choose between paying bills and buying food. Twenty-seven percent (27%) of adults experienced four or more adverse childhood experiences (ACEs) in their lifetime (ACEs are stressful or traumatic events, for example, parents becoming separated or divorced, or living with someone who was a problem drinker or alcoholic).


LATINO ENVIRONMENTAL HEALTH

Lucas County Latino adults reported the following as the top four issues that threatened their health in the past year: bed bugs (10%), mold (8%), air quality (6%), and plumbing problems (5%). Ten percent (10%) of Latino adults reported they had a disaster plan in preparation of a disaster.

27%

20%

36%

28%

3%

18%

31%

0%

10%

20%

30%

40%

50%

Lucas Latino 2020 Male Female 30-64 Years 65 & Over Income <$25K Income $25K Plus

Lucas County Latino Adults Who Experienced Four or More ACEs

DATA SUMMARY | 35

Data Summary | Youth Health

YOUTH WEIGHT STATUS Nearly one-fifth (17%) of Lucas County youth were obese, according to body mass index (BMI) by age. When asked how they would describe their weight, 29% of Lucas County youth reported that they were slightly or very overweight. Eighteen percent (18%) of youth did not participate in at least 60 minutes of physical activity on any day in the past week. Twelve percent (12%) of youth reported they went to bed hungry at least one day per week because their family did not have enough money for food. YOUTH TOBACCO USE Three percent (3%) of Lucas County youth were current smokers (having smoked at some time in the past month). Twelve percent (12%) of youth used e-cigarettes/vapes in the past year. Of youth who had used e-cigarettes/vapes in the past year, 56% put e-liquid or e-juice with nicotine in them.


17% 18% 16% 12%19% 22%

13%

13% 11% 15%15%

13% 10%11%

67% 67% 67% 70% 65% 67%71%

3% 4% 2% 3% 3% 1% 5%

0%

20%

40%

60%

80%

100%

Lucas 2019 Male Female 13 or Younger 14 to 16 17 & Older Lucas '16-17

Lucas County 6th-12th Grade Youth BMI Classifications

Obese Overweight Normal Weight Underweight

3% 3%2%

1% 1%

9%

3%

0%

5%

10%

15%


Lucas County 6th-12th Grade Youth Who Were Current Smokers

DATA SUMMARY | 36

YOUTH ALCOHOL CONSUMPTION In 2019, 12% of Lucas County youth had at least one drink in the past month, defining them as a current drinker. Of Lucas County youth who drank, 57% were defined as binge drinkers. Fourteen percent (14%) of all Lucas County youth had ridden in a car driven by someone who had been drinking alcohol in the past month. . YOUTH DRUG USE Twelve percent (12%) of Lucas County youth had used marijuana at least once in the past month. Twelve percent (12%) of youth used Ritalin, Adderall, Concerta, or other ADHD medications not prescribed for them or took more than was prescribed to feel good or get high at some time in their lifetime.


12%

9%

15%

6%

13%

27%

17%

0%

5%

10%

15%

20%

25%

30%


Lucas County 6th-12th Grade Youth Who Were Current Drinkers

1%

2%

<1%

0% 0%

1%

2%

<1%

0% 0%

<1% 1% <1%

0% 0%

1%

2%

1% 1% 1%

0%

1%

2%

3%

4%

5%

Steroids Inhalants Cocaine Heroin Meth

Lucas County Youth Lifetime Drug Use

Lucas 2019 Male Female Lucas '16-17

DATA SUMMARY | 37

YOUTH PERCEPTIONS OF SUBSTANCE USE In 2019, 74% of Lucas County youth thought there was a great risk in harming themselves if they used prescription drugs not prescribed to them. Seventy-eight percent (78%) of youth reported their parents would disapprove of them smoking cigarettes. YOUTH SEXUAL BEHAVIOR Nineteen (19%) of Lucas County youth had sexual intercourse in their lifetime. Eighteen percent (18%) of sexually active youth had four or more sexual partners in their lifetime. Six percent (6%) of youth engaged in intercourse without a reliable method of protection, and 30% reported they were unsure if they used a reliable method. YOUTH MENTAL HEALTH Seventeen percent (17%) of youth had seriously considered attempting suicide in the past year, and 10% attempted suicide in the past year. Over two-fifths (41%) of Lucas County youth reported academic success caused them anxiety, stress, or depression. One-fourth (25%) of youth had experienced three or more adverse childhood experiences (ACEs) in their lifetime (ACEs are stressful or traumatic events, for example, parents becoming separated or divorced, or living with someone who was a problem drinker or alcoholic).


17%

9%

23%

13%

18%

23%

12%

0%

5%

10%

15%

20%

25%

30%


Lucas County 6th-12th Grade Youth Who Had Seriously Considered Attempting Suicide in the Past Year

19% 18%20%

2%

25%

41%

29%

0%

10%

20%

30%

40%

50%


Lucas County 6th-12th Grade Youth Who Had Sexual Intercourse in their Lifetime

DATA SUMMARY | 38

8%

6%

9% 9%

7%8%

6%

0%

5%

10%

15%


Lucas County 6th-12th Grade Youth Threatened or Injured with a Weapon on School Property During the Past Year

YOUTH SOCIAL DETERMINANTS OF HEALTH Seventy percent (70%) of Lucas County youth had been to the dentist in the past year. Twelve percent (12%) of youth drivers had texted while driving in the past month. Forty-five percent (45%) of youth who had a social media or online gaming account believed that sharing information online is dangerous. YOUTH VIOLENCE Two percent (2%) of Lucas County youth carried a weapon (such as a gun, knife or club) on school property in the past month. Thirty percent (30%) of youth were involved in a physical fight in the past year. One-third (33%) of youth were bullied in the past year.


DATA SUMMARY | 39

Data Summary | Child Health HEALTH AND FUNCTIONAL STATUS In 2020, 16% of children were classified as obese by body mass index (BMI) calculations. More than four-fifths (82%) of Lucas County parents had taken their child to the dentist in the past year. Ten percent (10%) of Lucas County parents reported their child had been diagnosed with asthma. Fourteen percent (14%) of parents reported their child had been diagnosed with ADD/ADHD. HEALTH CARE ACCESS In 2020, 1% of Lucas County parents reported their child did not currently have health insurance. Thirteen percent (13%) of parents reported their child did not get all of the prescription medications they needed in the past year. Ninety-six percent (96%) of parents had taken their child to the doctor for preventive care in the past year. EARLY CHILDHOOD (0-to-5-YEARS-OLD) The following information was reported by parents of 0-5 year olds. Ninety-four percent (94%) of mothers got prenatal care within the first three months during their last pregnancy. Sixteen percent (16%) of mothers received WIC services during their last pregnancy. Ninety percent (90%) of parents put their child to sleep on his/her back. Sixteen percent (16%) of mothers never breastfed their child. MIDDLE CHILDHOOD (6-to-11-YEARS-OLD) The following information was reported by Lucas County parents of 6-11 year olds. Ninety-two percent (92%) of parents reported their child participated in extracurricular activities. More than three-fourths (77%) of parents reported their child was physically active for at least 60 minutes on three or more days per week. FAMILY AND COMMUNITY CHARACTERISTICS Five percent (5%) of parents reported someone in their household went to bed hungry at least one day per week because they did not have enough money for food. Sixty-five percent (65%) of parents reported their neighborhood was always safe for their child to go out and play. Seven percent (7%) of parents reported their child experienced two or more adverse childhood experiences (ACEs) in their lifetime (ACEs are stressful or traumatic events, for example, parents becoming separated or divorced, or living with someone who was a problem drinker or alcoholic). PARENT HEALTH In 2020, 61% of parents rated their health as excellent or very good, decreasing to 33% of parents with annual incomes less than $25,000. In the past year, 56% of parents missed work due to their child’s illnesses or injuries.

ADULT TREND SUMMARY | 40

ADULT TREND SUMMARY

N/A - Not Available *2018 BRFSS Data ‡2017 BRFSS as compiled by 2020 County Health Rankings

Indicates alignment with the Ohio State Health Assessment

Adult Variables Lucas

County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Health Status and Coverage

Rated health as excellent or very good 51% 48% 45% 49% 45% 48% 51%

Rated general health as fair or poor 14% 18% 18% 14% 17% 19% 18%

Rated mental health as not good on four or more days (in the past month)

26% 25% 26% 37% 34% N/A N/A

Rated physical health as not good on four or more days (in the past month)

N/A N/A 22% 24% 25% N/A N/A

Average number of days that mental health was not good (in the past month) (County Health Rankings)

N/A N/A 4.3 6.0 5.5 4.6‡ 4.0‡

Average number of days that physical health not good (in the past month) (County Health Rankings)

N/A N/A 4.0 4.8 4.2 3.9‡ 3.8‡

Poor physical or mental health kept them from doing usual activities, such as self-care, work, or recreation (on at least one day during the past month)

N/A N/A N/A 35% 35% N/A N/A

Uninsured 12% 13% 14% 6% 8% 9% 11%

Arthritis, Asthma, & Diabetes

Had been diagnosed with diabetes 12% 13% 15% 12% 13% 12% 11%

Had been diagnosed with arthritis 27% 19% 19% 23% 18% 31% 26%

Had been diagnosed with asthma 12% 13% 13% 10% 13% 11% 10%

Cardiovascular Health

Had angina 7% 3% 5% 2% 4% 5% 4%

Had a heart attack N/A 3% 5% 5% 4% 5% 4%

Had a stroke N/A 2% 3% 3% 3% 4% 3%

Had been diagnosed with high blood pressure

35% 34% 37% 34% 39% 35% 32%

Had been diagnosed with high blood cholesterol

34% 27% 25% 25% 27% 33% 33%

Had their blood cholesterol checked within the last five years

72% 76% 80% 77% 81% 85% 87%

Weight Status

Overweight (BMI of 25.0 – 29.9) 37% 36% 34% 38% 34% 35% 35%

Obese (includes severely and morbidly obese, BMI of 30.0 and above)

33% 35% 36% 36% 38% 35% 32%

Alcohol Consumption Current drinker (had at least one drink of alcohol within the past month)

57% 57% 54% 65% 60% 53% 54%

Binge drinker (males having five or more drinks on one occasion, females having four or more drinks on one occasion)

18% 23% 21% 24% 22% 18% 17%

Drove after having perhaps too much alcohol to drink (in the past month)

N/A N/A N/A 8% 12% 4%* 3%*

Tobacco Use Current smoker (smoked on some or all days) 23% 24% 19% 14% 15% 21% 16% Former smoker (smoked 100 cigarettes in lifetime and now do not smoke)

25% 23% 25% 23% 25% 24% 25%

Tried to quit smoking in the past year 85% 75% 74% 50% 56% N/A N/A

Used chewing tobacco or snuff in the past year N/A N/A 3% 3% 2% N/A N/A

ADULT TREND SUMMARY | 41

N/A - Not Available *2018 BRFSS Data **2015 BRFSS Data ‡ Includes all women regardless of age

Adult Variables Lucas

County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Drug Use

Adults who used marijuana in the past six months

9% 11% 10% 12% 7% N/A N/A

Adults who misused prescription drugs in the past six months

6% 8% 10% 6% 8% N/A N/A

Adults who used heroin in the past six months <1% 1% <1% <1% <1% N/A N/A Sexual Behavior

Had more than one sexual partner in past year 10% 9% 8% 12% 7% N/A N/A

Preventive Medicine

Had a flu vaccine in the past year 31% 37% 53% 52% 57% N/A N/A

Had a flu vaccine in the past year (ages 65 and older)

N/A 62% 74% 73% 77% 63% 64%

Ever had a pneumonia vaccine in lifetime (ages 65 and older)

59% 61% 56% 71% 73% 75% 73%

Ever had a shingles or zoster vaccine N/A N/A 8% 18% 20% 29% 29%* Had a clinical breast exam in the past two years (ages 40 and older)

N/A N/A 72% 70% 71% N/A N/A

Had a mammogram within the past two years (ages 40 and older)

73% 74% 73% 75% 76% 74%* 72%*

Had a Pap smear in the past three years (ages 21-65)

77%‡ 72%‡ 73%‡ 68%‡ 77% 79%* 80%*

Had a digital rectal exam within the past year 30% 26% 22% 18% 17% N/A N/A

Quality of Life Limited in some way because of physical, mental or emotional problem

42% N/A 47% 43% 37% 21%** 20%**

Mental Health

Considered attempting suicide in the past year 3% 3% 3% 2% 5% N/A N/A

Oral Health Visited a dentist or a dental clinic (within the past year)

66% 68% 66% 66% 64% 67%* 68%*

MINORITY ADULT TREND SUMMARY | 42

MINORITY ADULT TREND SUMMARY In addition to the general survey mailing, the Healthy Lucas County Executive Committee determined it would be beneficial to create individual trend summary tables for the African American and Latino populations. Additionally, sections were created for both adult populations to identity disparities among the African American and Latino communities. Please reference the table of contents to view individual section placement within the report. The child data did not include enough African American or Latino responses to break the data down into a child-specific minority trend summary table.

N/A - Not Available *2018 BRFSS Data ‡2017 BRFSS as compiled by 2020 County Health Rankings


Adult Variables

Lucas County Whites 2020

Lucas County Latinos

2020

Lucas County African

Americans2020

Lucas County 2020

Ohio 2019

U.S. 2019


Rated health as excellent or very good 50% 45% 36% 45% 48% 51%

Rated general health as fair or poor 13% 15% 25% 17% 19% 18%


36% 33% 43% 34% N/A N/A


23% 23% 30% 25% N/A N/A


5.4 4.9 6.1 5.5 4.6‡ 4.0‡


3.7 3.5 4.9 4.2 3.9‡ 3.8‡


36% 27% 34% 35% N/A N/A

Uninsured 5% 10% 11% 8% 9% 11%


Had been diagnosed with diabetes 11% 13% 15% 13% 12% 11%

Had been diagnosed with arthritis 17% 11% 23% 18% 31% 26%

Had been diagnosed with asthma 11% 13% 19% 13% 11% 10%


Had angina 3% 2% 5% 4% 5% 4%

Had a heart attack 3% 6% 5% 4% 5% 4%

Had a stroke 2% 5% 4% 3% 4% 3%

Had been diagnosed with high blood pressure

34% 32% 55% 39% 35% 32%


27% 21% 31% 27% 33% 33%

Had blood cholesterol checked within the past five years

79% 82% 84% 81% 85% 87%

Weight Status Overweight (BMI of 25.0 – 29.9) 34% 29% 34% 34% 35% 35% Obese (includes severely and morbidly obese, BMI of 30.0 and above)

32% 51% 45% 38% 35% 32%

MINORITY ADULT TREND SUMMARY | 43

N/A - Not Available *2018 BRFSS Data **2015 BRFSS Data


Adult Variables

Lucas County Whites 2020


2020


Americans2020

Lucas County 2020

Ohio 2019

U.S. 2019

Alcohol Consumption

Current drinker (had at least one drink of alcohol within the past month)

66% 53% 46% 60% 53% 54%


26% 37% 20% 22% 18% 17%


11% 12% 5% 12% 4%* 3%*

Tobacco Use

Current smoker (smoked on some or all days) 16% 14% 21% 15% 21% 16%

Former smoker (smoked 100 cigarettes in lifetime and now do not smoke)

26% 30% 18% 25% 24% 25%

Tried to quit smoking in the past year 53% 42% 63% 56% N/A N/A

Used chewing tobacco or snuff in the past year 2% 1% 3% 2% N/A N/A Drug Use


11% 7% 11% 7% N/A N/A


7% 6% 9% 8% N/A N/A

Adults who used heroin in the past six months 1% 0% 1% <1% N/A N/A

Sexual Behavior

Had more than one sexual partner in past year 6% 10% 6% 7% N/A N/A

Preventive Medicine

Had a flu vaccine in the past year 56% 65% 55% 57% N/A N/A


77% 87% 76% 77% 63% 64%


77% 70% 70% 73% 75% 73%

Ever had a shingles or zoster vaccine 21% 16% 23% 20% 29% 29%*

Had a clinical breast exam in the past two years (ages 40 and older)

70% 87% 68% 71% N/A N/A


73% 94% 76% 76% 74%* 72%*


78% 89% 77% 77% 79%* 80%*

Had a digital rectal exam within the past year 18% 5% 22% 17% N/A N/A

Quality of Life

Limited in some way because of physical, mental or emotional problem

32% 35% 45% 37% 21%** 20%**

Mental Health

Considered attempting suicide in the past year 5% 4% 9% 5% N/A N/A

Oral Health Visited a dentist or a dental clinic (within the past year)

71% 58% 44% 64% 67%* 68%*

LATINO ADULT TREND SUMMARY | 44

LATINO ADULT TREND SUMMARY

Adult Variables


2007


2011


2014


2017


2020

Lucas County 2020

Ohio Latinos

2018

U.S. Latinos

2018


Rated health as excellent or very good 55% 38% 39% 29% 45% 45% 57% 38%

Rated general health as fair or poor 15% 20% 17% 25% 15% 17% 12% 26% Rated their mental health as not good on four or more days in the previous month

23% 33% 38% 34% 33% 34% N/A 23%

Rated physical health as not good on four or more days (in the past month) 19% 32% 20% 34% 23% 25% 8% 23%


N/A N/A N/A 6.5 4.9 5.5 N/A N/A


N/A N/A N/A 7.5 3.5 4.2 N/A N/A


N/A N/A N/A 41% 27% 35% 33% 23%

Uninsured 13% 17% 19% 10% 10% 8% 18% 28%


Had been diagnosed with diabetes 11% 17% 21% 16% 13% 13% 10% 12%

Had been diagnosed with arthritis 18% 15% 13% 20% 11% 18% 34% 16%

Had been diagnosed with asthma 13% 13% 15% 7% 13% 13% 24% 13%


Had angina 4% 2% 5% 3% 2% 4% N/A 3%

Had a heart attack N/A 3% 4% 3% 6% 4% N/A 4%

Had a stroke N/A 4% 2% 6% 5% 3% N/A 2%

Had been diagnosed with high blood pressure 21% 33% 28% 33% 32% 39% N/A N/A

Had been diagnosed with high blood cholesterol 29% 25% 17% 17% 21% 27% N/A N/A

Had blood cholesterol checked within the past 5 years 64% 68% 73% 69% 82% 81% N/A N/A

Weight Status

Overweight (BMI of 25.0 – 29.9) 35% 37% 30% 38% 29% 34% 20% 38% Obese (includes severely and morbidly obese, BMI of 30.0 and above) 33% 42% 49% 42% 51% 38% 38% 34%

Alcohol Consumption

Current drinker (had at least one drink of alcohol within the past month) 47% 57% 51% 57% 53% 60% 48% 46%


N/A 29% 25% 41% 37% 22% 17% 18%

Drove after having perhaps too much alcohol to drink (in the past month) N/A N/A N/A 6% 12% 12% N/A N/A

N/A - Not Available Indicates alignment with Ohio State Health Assessment

LATINO ADULT TREND SUMMARY | 45

Adult Variables


2007


2011


2014


2017


2020

Lucas County 2020

Ohio Latinos

2018

U.S. Latinos

2018

Tobacco Use

Current smoker (smoked on some or all days) 26% 25% 11% 26% 14% 15% 29% 12%

Former smoker (smoked 100 cigarettes in lifetime and now do not smoke) 18% 17% 22% 19% 30% 25% 18% 18%

Tried to quit smoking in the past year N/A N/A N/A 41% 42% 56% N/A N/A

Used chewing tobacco or snuff in the past year N/A N/A N/A 1% 1% 2% N/A N/A

Drug Use Adults who used marijuana in the past six months 10% 10% 11% 9% 7% 7% N/A N/A

Adults who misused prescription drugs in the past six months 4% 7% 11% 6% 6% 8% N/A N/A

Adults who used heroin in the past six months 0% 0% 0% 0% 0% <1% N/A N/A

Sexual Behavior

Had more than one sexual partner in the past year 7% 10% 9% 14% 10% 7% N/A N/A

Preventive Medicine

Had a flu vaccine in the past year 31% 37% 52% 40% 65% 57% 33% 25%

Had a flu vaccine in the past year (ages 65 and older) 75% 64% 82% 84% 87% 77% N/A 50%

Had a pneumonia vaccine (age 65 and older) 53% 52% 67% 70% 70% 73% N/A 56%

Ever had a shingles or zoster vaccine N/A N/A 7% 7% 16% 20% N/A N/A

Had a clinical breast exam in the past two years (ages 40 and older) 77% 64% 70% 69% 87% 71% N/A N/A

Had a mammogram within the past two years (ages 40 and older) 67% 74% 80% 64% 94% 76% 72% 72%

Had a Pap smear in the past three years (ages 21-65) N/A N/A 61%* 69%* 89% 77% 61% 80%

Had a digital rectal exam within the past year 21% 17% 15% 14% 5% 17% N/A N/A

Quality of Life Limited in some way because of physical, mental or emotional problem 41% N/A 46% 40% 35% 37% N/A N/A

Mental Health

Considered attempting suicide in the past year N/A 7% 8% 7% 4% 5% N/A N/A

Oral Health Visited a dentist or a dental clinic (within the past year) 68% 56% 61% 39% 58% 64% 65% 59%

N/A - Not Available *Includes all women regardless of age


AFRICAN AMERICAN ADULT TREND SUMMARY | 46

AFRICAN AMERICAN ADULT TREND SUMMARY

*2017 BRFSS Data Indicates alignment with the Ohio State Health Assessment

Adult Variables


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Lucas County 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


Rated health as excellent or very good 37% 36% 29% 44% 36% 45% 43% 44%

Rated general health as fair or poor 25% 26% 29% 20% 25% 17% 23% 21% Rated their mental health as not good on four or more days in the previous month 30% 29% 32% 33% 43% 34% 29% 26%

Rated physical health as not good on four or more days (in the past month) 31% 34% 22% 26% 30% 25% 24% 23%


N/A N/A N/A 6.0 6.1 5.5 N/A N/A


N/A N/A N/A 6.5 4.9 4.2 N/A N/A


N/A N/A N/A 38% 34% 35% 24% 25%

Uninsured 12% 25% 25% 3% 11% 8% 10% 14%


Had been diagnosed with diabetes 22% 17% 21% 22% 15% 13% 13% 15%

Had been diagnosed with arthritis 31% 22% 18% 22% 23% 18% 28% 25%

Had been diagnosed with asthma 15% 14% 15% 14% 19% 13% 16% 18%


Had angina 10% 1% 5% 2% 5% 4% 3% 4%

Had a heart attack N/A 1% 8% 4% 5% 4% 5% 4%

Had a stroke N/A 2% 4% 6% 4% 3% 6% 5% Had been diagnosed with high blood pressure 54% 44% 49% 44% 55% 39% 40%* N/A

Had been diagnosed with high blood cholesterol 37% 21% 23% 24% 31% 27% 28%* N/A

Had blood cholesterol checked within the past 5 years 75% 69% 79% 68% 84% 81% 88%* N/A


N/A - Not Available Indicates alignment with the Ohio State Health Assessment

Adult Variables


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Lucas County 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Weight Status

Overweight (BMI of 25.0 – 29.9) 37% 28% 35% 27% 34% 34% 34% 33% Obese (includes severely and morbidly obese, BMI of 30.0 and above) 44% 47% 39% 58% 45% 38% 36% 40%

Alcohol Consumption Current drinker (had at least one drink of alcohol within the past month) 40% 43% 46% 42% 46% 60% 49% 47%


N/A 21% 21% 32% 20% 22% 18% 13%

Drove after having perhaps too much alcohol to drink (in the past month) N/A N/A N/A 7% 5% 12% N/A N/A

Drug Use Adults who used marijuana in the past six months 9% 17% 20% 7% 11% 7% N/A N/A

Adults who misused prescription drugs in the past six months 10% 8% 11% 11% 9% 8% N/A N/A

Adults who used heroin in the past six months <1% 0% 1% 1% 1% <1% N/A N/A

Tobacco Use

Current smoker (smoked on some or all days) 26% 25% 33% 17% 21% 15% 24% 17% Former smoker (smoked 100 cigarettes in lifetime and now do not smoke) 20% 17% 15% 18% 18% 25% 18% 15%

Tried to quit smoking in the past year N/A N/A N/A 67% 63% 56% 63% 69%

Used chewing tobacco or snuff in the past year N/A N/A N/A 1% 3% 2% N/A N/A

Sexual Behavior Had more than one sexual partner in past year 20% 20% 17% 26% 6% 7% N/A N/A


N/A - Not Available *Includes all women regardless of age

Adult Variables


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Lucas County 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Preventive Medicine

Had a flu vaccine in the past year 28% 28% 40% 59% 55% 57% 31% 28% Had a flu vaccine in the past year (ages 65 and older) 46% 67% 55% 73% 76% 77% 52% 47%

Had a pneumonia vaccination (ages 65 and over) 44% 55% 51% 71% 70% 73% 69% 60%

Ever had a shingles or zoster vaccine N/A N/A N/A 12% 23% 20% N/A N/A Had a clinical breast exam in the past two years (ages 40 and older) 78% 79% 74% 81% 68% 71% 83% N/A

Had a mammogram within the past two years (ages 40 and older) 78% 76% 79% 80% 76% 76% 81% 78%

Had a Pap smear in the past three years (ages 21-65) N/A N/A 78%* 77%* 77% 77% N/A 85%

Had a digital rectal exam within the past year 37% 34% 21% 7% 22% 17% N/A N/A

Quality of Life

Limited in some way because of physical, mental or emotional problem 53% N/A 49% 56% 45% 37% N/A N/A

Mental Health

Considered attempting suicide in the past year N/A 3% 5% 2% 9% 5% N/A N/A

Oral Health

Visited a dentist or a dental clinic (within the past year) 55% 60% 51% 63% 44% 64% 64% 61%

YOUTH TREND SUMMARY | 49

YOUTH TREND SUMMARY

N/A – Not Available Indicates alignment with the Ohio State Health Assessment

Youth Variables

Lucas County

2019 (6th-12th)

Lucas County 2011

(9th-12th)

Lucas County 2013/14 (9th-12th)


Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Weight Control

Obese 17% 15% 13% 15% 19% 17% 16%

Overweight 13% 11% 11% 12% 12% 12% 16%

Described themselves as slightly or very overweight

29% 25% 25% 30% 33% N/A 32%

Exercised to lose weight 36% 43% 48% 42% 36% N/A N/A

Ate less food, fewer calories, or foods lower in fat to lose weight

26% 28% 31% 26% 30% N/A N/A

Went without eating for 24 hours or more

6% 7% 6% 4% 6% N/A N/A

Took diet pills, powders, or liquids without a doctor’s advice

2% 3% 2% 1% 2% N/A N/A

Vomited or took laxatives 2% 3% 3% 1% 3% N/A N/A

Ate one to four servings of fruits and vegetables per day

67% 82% 81% 87% 70% N/A N/A

Physically active at least 60 minutes per day on every day in past week

21% 28% 28% 23% 20% 23% 23%

Physically active at least 60 minutes per day on five or more days in past week

40% 43% 50% 44% 40% 43% 44%

Did not participate in at least 60 minutes of physical activity on any day in the past week

18% 15% 15% 14% 18% 21% 17%

Watched three or more hours per day of television (on an average school day)

20% 40% 34% 18% 18% N/A 20%

Unintentional Injuries and Violence

Were in a physical fight (in past year) 30% 28% 25% 23% 26% 19% 22%

Carried a weapon on school property (in the past month)

2% N/A 9% N/A 2% N/A 3%

Threatened or injured with a weapon on school property (in past year)

8% N/A 7% 7% 8% N/A 7%

Did not go to school because they felt unsafe (at school or on their way to or from school in the past 30 days)

11% 6% 6% 4% 17% N/A 9%

Electronically bullied (in past year) 9% 15% 12% 12% 11% 13% 16%

Bullied (in past year) 33% 43% 38% 35% 33% N/A N/A

Bullied on school property (in past year)

20% N/A 22% 17% 17% 14% 20%

Ever purposefully hurt themselves 35% 23% 10% N/A 31% N/A N/A Mental Health

Seriously considered attempting suicide (in the past year)

17% 16% 18% 14% 19% 16% 19%

Attempted suicide (in past year) 10% 4% 8% 8% 11% 7% 9% Felt sad or hopeless (almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past 12 months)

38% 24% 29% 29% 45% 33% 37%


Youth Variables

Lucas County

2019 (6th-12th)

Lucas County

2011 (9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Alcohol Consumption Current drinker (at least one drink of alcohol on at least one day during the past month)

12% 39% 28% 27% 19% 26% 29%

Binge drinker (drank five or more drinks within a couple of hours on at least one day during the past month)

7% 23% 21% 13% 12% 13% 14%

Obtained the alcohol they drank by someone giving it to them (of youth drinkers)

34% 21% 14% N/A 31% N/A 41%

Rode with a driver who had been drinking alcohol (in a car or other vehicle on one or more occasion during the past month)

14% 25% 21% 19% 14% N/A 17%

Drove when they had been drinking alcohol (of youth drivers on one or more occasion during the past month)

4% 9% 5% 6% 4% N/A 5%

Drank for the first time before age 13 (of all youth) 12% 18% 12% 8% 8% 16% 15%

Tobacco Use Currently smoked cigarettes (on at least one day during the past month)

3% 18% 9% 5% 4% 5% 6%

Smoked a whole cigarette before the age of 13 (for the first time of all youth)

5% 6% 5% 4% 4% N/A 7%**

Tried to quit smoking (of youth who smoked in the past year)

47% 46%* 40%* 34%* 31% N/A 48%

Smoked cigarettes frequently (of current smokers on twenty or more days during the past month)

1% N/A N/A 2% 1% 1% 1%

Sexual Behavior

Ever had sexual intercourse 19% 63% 53% 42% 32% 38% 38%

Participated in anal sex 3% 16% 6% 8% 5% N/A N/A

Participated in oral sex 17% 46% 44% 35% 30% N/A N/A

Participated in sexting 20% 40% 34% 37% 31% N/A N/A

Had viewed pornography 23% N/A 37% 42% 31% N/A N/A

Used a condom (during last sexual intercourse) 31% 75% 68% 58% 24% 45% 54%

Used birth control pills (during last sexual intercourse)

10% 20% 26% 15% 9% 32% 23%

Used an IUD (during last sexual intercourse)

8% 8% 7% 1% 7% 5% 5%

Used a shot, patch or birth control ring (during last sexual intercourse)

5% 8% 7% 3% 5% N/A N/A

Did not use any method to prevent pregnancy during last sexual intercourse

6% 7% 10% 13% 5% 12% 12%

Had sexual intercourse with four or more persons (of all youth during their life)

4% 27% 21% 15% 8% 8% 9%

Had sexual intercourse before the age 13 (for the first time of all youth)

2% 12% 10% 7% 2% 3% 3%

N/A – Not Available Indicates alignment with the Ohio State Health Assessment

*Tried to quit smoking only cigarettes


Youth Variables

Lucas County

2019 (6th-12th)

Lucas County

2011 (9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Drug Use Currently used marijuana (in the past month)

12% 26% 19% 18% 16% 16% 22%

Ever used cocaine (in their lifetime) <1% 4% 3% 2% <1% 4% 4%

Ever used heroin (in their lifetime) 0% 2% 1% 1% 0% 2% 2%

Ever used methamphetamines (in their lifetime)

0% 3% 2% 1% 0% N/A 2%

Ever took steroids without a doctor's prescription (in their lifetime)

1% 4% 4% 1% 1% N/A 2%

Ever used inhalants (in their lifetime) 2% 9% 5% 3% 2% 8% 6%

Ever used ecstasy (also called MDMA in their lifetime)

1% N/A 3% 2% 1% N/A 4%

Social Determinants of Health Visited a dentist within the past year (for a check-up, exam, teeth cleaning, or other dental work)

70% 79% 77% 76% 68% 78% 76%

Diagnosed with asthma 21% N/A N/A 24% 24% 24% 22%

N/A – Not Available

MINORITY YOUTH TREND SUMMARY | 52

MINORITY YOUTH TREND SUMMARY

Youth Variables

Lucas County White 2019

(6th-12th)


Americans 2019

(6th-12th)


2019 (6th-12th)

Lucas County

2019 (6th-12th)


(9th-12th)


Americans 2019

(9th-12th)


2019 (9th-12th)

Lucas County

2019 (9th-12th)

Weight Control

Obese 17% 19% 19% 17% 20% 18% 21% 19%

Overweight 10% 14% 21% 13% 11% 13% 19% 12%


30% 27% 39% 29% 37% 25% 40% 33%

Exercised to lose weight (in the past month) 38% 32% 31% 36% 37% 31% 34% 36%

Ate less food, fewer calories, or foods lower in fat to lose weight (in the past month)

30% 19% 42% 26% 36% 21% 39% 30%

Went without eating for 24 hours or more (in the past month)

6% 6% 8% 6% 6% 7% 2% 6%

Took diet pills, powders, or liquids without a doctor’s advice (in the past month)

1% 2% 3% 2% 1% 3% 2% 2%

Vomited or took laxatives (in the past month)

2% 3% 3% 2% 3% 2% 4% 3%


69% 63% 69% 67% 72% 67% 72% 87%


24% 18% 21% 21% 19% 22% 14% 20%


44% 36% 35% 40% 41% 39% 33% 40%


17% 22% 17% 18% 15% 23% 18% 18%


16% 26% 25% 20% 16% 22% 19% 18%

Unintentional Injuries and Violence

Were in a physical fight (in past year)

24% 36% 39% 30% 21% 33% 30% 26%


1% 3% 1% 2% 1% 5% 0% 2%


6% 8% 13% 8% 7% 8% 6% 8%

Did not go to school because they felt unsafe (at school or on their way to or from school in the past 30 days)*

10% 10% 15% 11% 13% 16% 23% 17%

Electronically bullied (in past year)

9% 6% 13% 9% 12% 7% 12% 11%

Bullied (in past year) 35% 29% 37% 33% 33% 32% 29% 33%


23% 13% 24% 20% 20% 11% 19% 17%

Ever purposefully hurt themselves

31% 35% 37% 35% 30% 31% 46% N/A



Youth Variables


(6th-12th)


Americans 2019

(6th-12th)


2019 (6th-12th)

Lucas County

2019 (6th-12th)


(9th-12th)


Americans 2019

(9th-12th)


2019 (9th-12th)

Lucas County 2019

(9th-12th)

Mental Health


13% 18% 27% 17% 17% 21% 21% 19%

Attempted suicide (in past year)

6% 9% 17% 10% 10% 10% 16% 11%

Felt sad or hopeless (almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past 12 months)

33% 40% 46% 38% 43% 49% 38% 45%

Alcohol Consumption

Current drinker (at least one drink of alcohol on at least one day during the past month)

12% 16% 11% 12% 21% 20% 15% 19%


7% 8% 7% 7% 13% 11% 7% 12%


14% 15% 15% 14% 13% 14% 17% 14%


2% 4% 10% 4% 3% 5% 9% 4%

Drank for the first time before age 13 (of all youth)

10% 12% 19% 12% 9% 9% 9% 8%

Tobacco Use

Currently smoked cigarettes (on at least one day during the past month)

2% 2% 3% 3% 4% 2% 6% 4%

Smoked a whole cigarette before the age of 13 (for the first time of all youth)

3% 8% 6% 5% 3% 6% 5% 4%

Tried to quit smoking (of youth who smoked in the past year)

52% 31% 59% 47% 52% 31% 53% 31%



Youth Variables


(6th-12th)


Americans 2019

(6th-12th)


2019 (6th-12th)

Lucas County

2019 (6th-12th)


(9th-12th)


Americans 2019

(9th-12th)


2019 (9th-12th)

Lucas County 2019

(9th-12th)

Sexual Behavior

Ever had sexual intercourse 19% 19% 21% 19% 38% 27% 34% 32%

Participated in anal sex 3% 1% 8% 3% 5% 2% 10% 5%

Participated in oral sex 18% 16% 23% 17% 33% 23% 40% 30%

Participated in sexting 21% 19% 22% 20% 35% 26% 37% 31%

Had viewed pornography 26% 18% 28% 23% 38% 20% 41% 31%

Used a condom (during last sexual intercourse)

32% 22% 16% 31% 37% 24% 56% 24%


21% 5% 2% 10% 27% 6% 3% 9%


8% 7% 3% 8% 10% 9% 6% 7%

Used a shot, patch, or birth control ring (during last sexual intercourse)

5% 8% 0% 5% 7% 6% 0% 5%


3% 7% 5% 6% 3% 9% 14% 5%


4% 4% 5% 18% 8% 7% 10% 18%


0% 4% 5% 2% 0% 3% 4% 2%

Drug Use

Currently used marijuana (in the past 30 days)

9% 12% 16% 12% 16% 15% 17% 16%

Ever used cocaine (in their lifetime) 1% 0% 1% <1% 1% 0% 1% <1%

Ever used heroin (in their lifetime)

0% 0% 0% 0% 0% 0% 0% 0%


0% 0% 0% 0% 0% 0% 0% 0%


1% 1% 1% 1% 1% 1% 2% 1%

Ever used inhalants (in their lifetime)

2% 1% 1% 2% 2% 1% 0% 2%


0% 2% 3% 1% 0% 2% 4% 1%

Social Determinants of Health

Visited a dentist within the past year (for a check-up, exam, teeth cleaning, or other dental work)

80% 62% 65% 70% 80% 59% 61% 68%

Diagnosed with asthma 17% 27% 25% 21% 22% 28% 25% 24%

CHILD TREND SUMMARY | 55

CHILD TREND SUMMARY

Child Comparisons

Lucas County 2014 Ages 0-5



Ohio 2017/ 2018 Ages 0-5

U.S. 2017/ 2018 Ages 0-5




Ohio 2017/ 2018 Ages 6-11

U.S. 2017/ 2018 Ages 6-11

Health and Functional Status Rated health as excellent or very good

91% 98% 99% 92% 93% 86% 97% 95% 89% 90%

Dental care visit in past year 64% 61% 64% 52%** 62%** 91% 94% 92% 93% 92%

Diagnosed with asthma 11% 5% 4% 4% 6% 17% 15% 14% 13% 13%

Diagnosed with ADHD/ADD 1% 0% 1% 1%* 2%* 14% 12% 22% 14% 10%

Diagnosed with behavioral or conduct problems

3% 0% 4% 3%* 5%* 5% 9% 9% 13% 10%

Diagnosed with depression 1% 0% 4% 0%* <1%* 2% 2% 6% 1% 2%

Diagnosed with epilepsy 0% 0% 0% N/A 1% 2% 1% 1% N/A 1%

Diagnosed with a head injury 1% 0% 0% N/A N/A 2% 1% 0% N/A N/A

Diagnosed with anxiety problems

2% 0% 3% 1%* 2%* 6% 10% 15% 9% 9%

Diagnosed with developmental delay

N/A 3% 0% 10%* 8%* N/A 10% 0% 8% 8%

Diagnosed with learning disability

3% 0% 0% 1%* 2%* 5% 6% 8% 11% 9%

Diagnosed with speech or language disorder

15% 10% 10% 6%* 11%* 9% 11% 16% 10% 10%

Two or more health conditions N/A N/A 6% 5% 7% N/A N/A 22% 23% 21%

Health Care Access

Had public insurance 28% 28% 17% 32% 33% 22% 26% 20% 25% 32%

Been to doctor for preventive care in past year

95% 96% 100% 92%¥ 89%¥ 88% 92% 93% 81%¥ 80%¥

Received all the medical care they needed

93% 99% 94% N/A N/A 94% 96% 86% N/A N/A

Had a personal doctor or nurse 56% 88% 84% 72% 72% 58% 85% 84% 77% 72%

Family had problems paying for child’s medical or health care bills (in past year)

N/A N/A 15% 7% 9% N/A N/A 10% 10% 11%

Family and Community Characteristics

Family ate a meal together every day of the week

50% 35% 51% 57% 54% 39% 35% 29%

44%

45%

Neighborhood is usually or always safe

89% 90% 95% N/A N/A 95% 91% 94% N/A N/A

Child experienced two or more ACEs

N/A N/A 0% 13% 10% N/A N/A 10% 27% 20%

Parent or family member quit a job, did not take a job, or greatly changed job because of problems with childcare for child (in past year)

N/A N/A 6% 10% 9% N/A N/A 5% N/A N/A

Primary language spoken at home was dialect other than English

N/A N/A 1% 5% 16% N/A N/A 1% 5% 14%

N/A – Not Available **Ages 1-5 *Ages 3-5 ¥2016/17 NSCH data


CHILD TREND SUMMARY | 56

Child Comparisons




Ohio 2017/ 2018 Ages 0-5

U.S. 2017/ 2018 Ages 0-5




Ohio 2017/ 2018 Ages 6-11

U.S. 2017/ 2018 Ages 6-11

Early Childhood (0-5 Year Olds)

Never breastfed their child 29% 22% 16% 20% 20% N/A N/A N/A N/A N/A

Child put to bed on their back 68% 81% 90% N/A N/A N/A N/A N/A N/A N/A

Middle Childhood (6-11 Year Olds) Child participated in one or more activities

N/A N/A N/A N/A N/A N/A N/A 92% 78% 78%

Parent Health Mother’s mental or emotional health was fair/poor

4% 10% 7% 9% 5% 8% 9% 13% 9% 5%

Father’s mental or emotional health was fair/poor

2% 6% 7% 7% 3% 1% 9% 6% 4% 3%

Mother’s physical health status is fair/poor

2% 6% 3% 3% 4% 2% 6% 9% 7% 6%

Father’s physical health status is fair/poor

2% 6% 11% 3% 5% 2% 6% 8% 7% 4%


HEALTH CARE COVERAGE | 57

Health Care Access: Health Care Coverage Key Findings In 2020, 8% of Lucas County adults were without health care coverage. Those most likely to be uninsured were adults younger than the age of 30 (20%) and those with annual income levels under $25,000 (11%). The top reason adults reported for being without health care coverage was cost (37%).

Health Care Coverage • In 2020, 92% of Lucas County adults had health care coverage, leaving 8% who were uninsured. • Twelve percent (12%) of adults with children did not have health care coverage, compared to 4% of those who

did not have children living in their household.

• The top reasons uninsured adults gave for being without health care coverage were: 1. They lost their job or changed employers (42%) 2. Cost (29%) 3. They became a part time or temporary employee (15%) 4. They became ineligible (13%) 5. They did not think they needed it (11%)

(Percentages do not equal 100% because respondents could select more than one reason)

• The following types of health care coverage were used: employer (47%); Medicare (21%); Medicaid or medical assistance (13%); someone else’s employer (9%); self-purchased plan (3%); multiple, including private insurance (2%); Health Insurance Marketplace (2%); multiple, including government insurance (1%); and military, CHAMPUS, TriCare, CHAMPVA or the VA (1%).

• Lucas County adults had the following issues regarding their health care coverage: — Cost (37%) — Opted out of certain coverage because they could not afford it (13%) — Could not understand their insurance plan (8%) — Limited visits (7%) — Opted out of certain coverage because they did not need it (6%) — Service not deemed medically necessary (6%) — Provider was no longer covered (6%) — Working with their insurance company (6%) — Service no longer covered (4%) — Pre-existing conditions (3%)

Adult Comparisons Lucas

County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Uninsured 12% 13% 14% 6% 8% 9% 11%

In Lucas County, 8% of adults, or approximately 26,137 adults were uninsured.


8%6%

11%

20%

8%

1%

11%

8%

5%

11% 10%

13% 14%

6%

0%

10%

20%

30%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25KPlus


Latino Lucas2011

Lucas2014

Lucas2017

Uninsured Lucas County Adults

The following graph shows the percentage of Lucas County adults who were uninsured. Examples of how to interpret the information include: 8% of Lucas County adults were uninsured, including 11% of adults with annual incomes less than $25,000 and 20% of those younger than the age of 30. The pie chart shows sources of Lucas County adults’ health care coverage.


Employer, 47%

Medicare, 21%

Medicaid, 13%

Self-purchased, 3%

Someone Else's Employer, 9%

Military, 1%

Health Insurance Marketplace, 2%

Multiple, including private insurance,

2%

Multiple, including government

insurance, 1%

Source of Health Coverage for Lucas County Adults


The following chart shows what is included in Lucas County adults’ insurance coverage.

Health Coverage Includes: Yes No Don’t Know

Medical 98% 1% 1%

Prescription Coverage 93% 4% 3%

Preventive Health (e.g., well visits, cancer screenings, blood pressure tests)

87% 3% 10%

Immunizations 83% 3% 14%

Dental 78% 19% 3%

Vision/Eyeglasses 75% 20% 5%

Outpatient Therapy (e.g., occupational therapy, physical therapy)

74% 3% 23%

Mental Health 70% 4% 26%

Durable Medical Equipment (e.g., canes, walkers, oxygen) 49% 6% 45%

Alcohol and Drug Treatment 43% 9% 48%

Home Care 35% 8% 57%

Skilled Nursing/Assisted Living (e.g., inpatient rehab/therapy)

34% 7% 59%

Hospice 32% 6% 62%

Transportation 26% 17% 57%

Healthy People 2020

Access to Health Services (AHS)

Note: U.S. baseline is age-adjusted to the 2000 population standard. (Sources: Healthy People 2020 Objectives, 2018 BRFSS, 2019/2020 Lucas County Health Assessment) Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

Objective Lucas County

2020 Ohio 2018

U.S. 2018

Healthy People 2020

Target

AHS-1.1: Increase the proportion of persons with medical insurance

100% age 18-24 79% age 25-34 96% age 35-44 93% age 45-54 91% age 55-64



100%

ACCESS AND UTILIZATION | 60

Health Care Access: Access and Utilization

Key Findings Eleven percent (11%) of Lucas County adults went outside of Lucas County for health care services in the past year. Twenty percent (20%) of adults looked for a program to help with depression, anxiety, or some mental health problem.

Health Care Access and Utilization • Adults usually visited the following places for health care services when they were sick or needed advice:

— Doctor’s office (88%) — Urgent care center (40%) — Hospital emergency room (26%) — Family and friends (22%) — Internet (17%) — Chiropractor (10%) — In-store health clinic (7%) — Alternative therapies (5%) — Telemedicine (4%) — Called 9-1-1/used an ambulance service (3%) — Community health center (3%) — Veterans Affairs (VA) (2%) — Health department (1%) — Some other place (1%) — Two percent (2%) of adults indicated they had no usual place for health care services.

• The following prevented Lucas County adults from getting medical care in the past year: no need to go (30%),

cost/no insurance (30%), office was not open when they could get there (7%), too long of a wait for an appointment (4%), did not trust or believe doctors (3%), no child care (2%), no transportation (1%), too embarrassed to seek help (1%), provider would not take their insurance (1%), distance (1%), concerned they would be treated differently (1%), and some other reason (12%).

• Eleven percent (11%) of adults went outside of Lucas County for health care services in the past year. Those that

went outside of Lucas County for health care services gave the following reasons: went there because they used to live there (27%), there was a better quality program (17%), service was not available locally (9%), the wait list was too long in Lucas County (8%), did not like local services/provider (5%), hours not convenient (5%), had insurance restrictions (4%), worked there (4%), word of mouth (3%), had a bad experience locally (3%), and other reasons (33%).

• One-fifth (20%) of adults did not get their prescriptions from their doctor filled in the past year. Adults

reported the following reasons for not getting their prescriptions filled in the past year: too expensive (59%), no insurance (24%), did not think they needed it (22%), no generic equivalent of what was prescribed (18%), did not have any prescriptions to be filled (17%), stretched current prescription by taking less than what was prescribed (15%), side effects (12%), fear of addiction (7%), transportation (3%), and they were already taking too many medications (3%).

• A living will is a written legal document that details adults’ wishes for end-of-life medical care if they are unable

to make decisions for themselves. More than one-fourth (26%) of Lucas County adults reported they had a living will, decreasing to 23% of those with annual incomes less than $25,000 and increasing to 57% of those over the age of 65.

During the past year, 30% of adults or approximately 98,015 adults did not receive medical care due to cost/no insurance.


• A durable power of attorney is a written legal document in which people name an individual who will make medical decisions for them when they are unable to do so. Eighteen percent (18%) of adults had a durable power of attorney, increasing to 43% of those over the age of 65 and decreasing to 17% of those with annual incomes less than $25,000.

• Of the Lucas County adults who did not have a living will or durable power of attorney, 82% had discussed their

medical wishes with a family member or loved one. Availability of Services

Lucas County Adults Able to Access Assistance Programs/Services


Types of Programs (% of all adults who looked for the programs)

Lucas County adults who looked but did NOT find a specific program

Lucas County adults who looked and found a specific program

Depression, anxiety, or some mental health problem (20% of all adults looked)

31% 69%

Weight problem (10% of all adults looked)

50% 50%

Disability (8% of all adults looked)

36% 64%

Assistance with in-home care for an elderly or disabled adult (6% of all adults looked)

39% 61%

Family planning (6% of all adults looked)

28% 72%

Tobacco cessation (5% of all adults looked)

54% 46%

Marital or family problems (5% of all adults looked)

47% 53%

Assist in care for the elderly (either in-home or out-of-home, or adult day care) (5% of all adults looked)

42% 58%

Assist in care for the disabled (either in-home or out-of-home) (5% of all adults looked)

39% 61%

Alcohol abuse (4% of all adults looked)

67% 33%

End-of-life care or hospice care (4% of all adults looked)

47% 53%

Assistance with out-of-home placement for an elderly or disabled adult (4% of all adults looked)

46% 54%

Assisted living program for an elderly or disabled adult (4% of all adults looked)

48% 52%


Availability of Services, Continued

Lucas County Adults Able to Access Assistance Programs/Services


Types of Programs (% of all adults who looked for the programs)

Lucas County adults who looked but did NOT find a specific program

Lucas County adults who looked and found a specific program

Drug abuse (3% of all adults looked)

56% 44%

Disabled adult program (3% of all adults looked)

55% 45%

Detoxification for opiates/heroin (3% of all adults looked)

53% 47%

Cancer support group/counseling (3% of all adults looked)

32% 68%

Day care for an elderly or disabled adult (2% of all adults looked)

79% 21%

Gambling abuse (1% of all adults looked)

100% 0%

PREVENTIVE MEDICINE | 63

Health Care Access: Preventive Medicine Key Findings More than half (57%) of Lucas County adults had a flu vaccine during the past year. Nearly three-fourths (73%) of adults ages 65 and older had a pneumonia vaccination at some time in their life.

Preventive Medicine

• More than half (57%) of Lucas County adults had a flu vaccine during the past year, increasing to 77% of those 65 and older.

• More than one-third (37%) of adults have had a pneumonia vaccine in their life, increasing to 73% of those ages 65 and older.

• Lucas County adults have had the following vaccines: — Measles, mumps, and rubella (MMR) in their lifetime (80%) — Tetanus, diphtheria, and pertussis in the past ten years (72%) — Chicken pox vaccine in their lifetime (66%) — Hepatitis B vaccine in their lifetime (43%) — Influenza type B vaccine in their lifetime (40%) — Hepatitis A vaccine in their lifetime (35%) — Hemophilus influenzae or influenza type B vaccine in their lifetime (30%) — Meningococcal vaccine in their lifetime (24%) — Zoster (shingles) vaccine in their lifetime (20%) — Human papillomavirus (HPV) vaccine in their lifetime (18%)

Preventive Health Screenings and Exams

• In the past year, 58% of Lucas County women ages 40 and older had a mammogram.

• Half (50%) of men had a digital rectal exam in their lifetime, and 17% had one in the past year.

• See the Women’s and Men’s Health Sections for further prostate, mammogram, clinical breast exam, and Pap smear screening test information for Lucas County adults.

Lucas County Adult Health Screening Results

General Screening Results Total Sample*

Diagnosed with High Blood Pressure 39%

Diagnosed with High Blood Cholesterol 27%

Diagnosed with Diabetes 13%

Survived a Heart Attack 4%

Survived a Stroke 3% *Percentages based on all Lucas County adults surveyed.


Health Care Topics Discussed by Lucas County Adults With Their Health Care Professional in the Past Year

Health Care Topics Total 2007

Total 2011

Total 2014

Total 2017

Total 2020

Alcohol use 9% 9% 7% 8% 12%

Child care N/A N/A N/A N/A 2%

Depression, anxiety, or emotional problems 16% 21% 20% 19% 28%

Domestic violence 4% 3% 2% 1% 3%

Drug abuse N/A N/A N/A N/A 4%

E-cigarettes/vaping N/A N/A N/A N/A 3%

Education N/A N/A N/A N/A 4%

Family history N/A N/A 17% 28% 36%

Family planning N/A N/A N/A 12% 5%

Financial strains N/A N/A N/A N/A 4%

Food access N/A N/A N/A N/A 9%

Housing N/A N/A N/A N/A 3%

Immunizations N/A N/A N/A N/A 29%

Injury prevention (e.g., safety belt use, helmet use & smoke detectors)

8% 10% 8% 6% 9%

Safe use of opiate-based pain medication (e.g., Percocet, Vicodin)

N/A 10% 10% 10% 8%

Safe use of prescription medication N/A N/A N/A 15% 21%

Sexually transmitted diseases (STDs) 11% 10% 7% 8% 10%

Social connections N/A N/A N/A N/A 6%

Tobacco use N/A N/A N/A 11% 14%

Training and employment N/A N/A N/A N/A 4%

Transportation N/A N/A N/A N/A 4%

Utilities N/A N/A N/A N/A 2%

Weight control (e.g., diet, physical activity) 78% 77% 76% 29% 30% N/A – Not Available


The following graph shows the percentage of Lucas County adults who received a flu vaccine within the past year. Examples of how to interpret the information shown on the graph include: 57% of Lucas County adults received a flu vaccine within the past year, including 57% of females and 64% of those with annual incomes less than $25,000.


Healthy People 2020 Immunization and Infectious Diseases (IID)

Note: U.S. baseline is age-adjusted to the 2000 population standard. (Sources: Healthy People 2020 Objectives, 2019/2020 Lucas County Community Health Assessment)


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Had a flu vaccine in the past year 31% 37% 53% 52% 57% N/A N/A


N/A 62% 74% 73% 77% 63% 64%


59% 61% 56% 71% 73% 75% 73%

Ever had a shingles or zoster vaccine N/A N/A 8% 18% 20% 29% 29%* N/A – Not Available *2018 BRFSS Data

Objective Lucas

County 2020

Healthy People 2020

Target

IID-13.1: Increase the percentage of non-institutionalized high-risk adults aged 65 years and older who are vaccinated against pneumococcal disease

73% 90%

IID-12.7: Increase the percentage of non-institutionalized high-risk adults aged 65 years and older who are vaccinated annually against seasonal influenza

77% 90%

IID-14: Increase the percentage of adults who are vaccinated against zoster (shingles)

20% 30%

57% 55% 57%

48%53%

77%

64%56% 56% 55%

65%

37%

53% 52%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults who Received a Flu Vaccine Within the Past Year

WOMEN’S HEALTH | 66

Health Care Access: Women’s Health Key Findings In 2020, over half (58%) of Lucas County women older than the age of 40 reported having a mammogram in the past year. In the past year, 55% of Lucas County women had a clinical breast exam, and 35% had a Pap smear to detect cancer of the cervix. More than one-third (39%) were obese, 34% had high blood pressure, 27% had high blood cholesterol, and 16% were identified as current smokers, of which are all known risk factors for cardiovascular diseases.

Women’s Health Screenings

• Sixty-eight percent (68%) of women had a mammogram at some time in their life, and two-fifths (40%) had this screening in the past year.

• More than half (58%) of women ages 40 and older had a mammogram in the past year, and 76% had one in the past two years.

• Ninety-three percent (93%) of Lucas County women had a clinical breast exam at some time in their life, and 55% had one within the past year. Seventy-one percent (71%) of women ages 40 and older had a clinical breast exam in the past two years.

• Ninety-four percent (94%) of Lucas County women had a Pap smear at some time in their life, and 36% reported having had the exam in the past year. Seventy-one percent (71%) of all Lucas County women had a Pap smear in the past three years. Six percent (6%) of women reported the screening was not recommended by their doctor.

Pregnancy • Sixteen percent (16%) of Lucas County women had been pregnant in the past five years. • Thinking back to their last pregnancy, 56% of women wanted to be pregnant then, 20% wanted to be pregnant

sooner, 15% did not want to be pregnant then or any time in the future, and 9% of women did not recall.

Women’s Health Concerns

• Women used the following as their usual source of services for female health concerns: private gynecologist (51%), general or family physician (30%), family planning clinic (4%), community health center (1%), emergency room (<1%), and some other kind of place (<1%). Ten percent (10%) of women indicated they did not have a usual source of services for female health concerns.

• Major risk factors for cardiovascular disease include smoking, obesity, high blood cholesterol, high blood

pressure, physical inactivity, and diabetes. In 2020, the health assessment identified that: 67% of women were overweight or obese (2018 BRFSS reports 64% for Ohio and 61% for U.S.) — 34% were diagnosed with high blood pressure (2018 BRFSS reports 33% for Ohio and 31% for U.S.) — 27% were diagnosed with high blood cholesterol (2018 BRFSS reports 33% for Ohio and 32% for U.S.) — 16% of all women were current smokers (2018 BRFSS reports 19% for Ohio and 14% for U.S.) — 12% were diagnosed with diabetes (2018 BRFSS reports 13% for Ohio and 11% for U.S.)

Lucas County Female Leading Causes of Death, 2016 – 2018

Total Female Deaths: 6,917

1. Heart Diseases (23% of all deaths) 2. Cancers (21%) 3. Chronic Lower Respiratory Diseases (7%) 4. Alzheimer’s disease (7%) 5. Stroke (7%)

(Source: Ohio Public Health Data Warehouse, 2016-2018)

Ohio Female Leading Causes of Death, 2016 – 2018

Total Female Deaths: 182,368

1. Heart Diseases (22% of all deaths) 2. Cancers (20%) 3. Chronic Lower Respiratory Diseases (6%) 4. Stroke (6%) 5. Alzheimer’s disease (6%)



The following graph shows the percentage of Lucas County female adults who had various health exams in the past year. Examples of how to interpret the information include: 40% of Lucas County females had a mammogram within the past year, 55% had a clinical breast exam, and 36% had a Pap smear.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup

is higher than that of the overall survey.

Adult Comparisons

Lucas County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2018

U.S. 2018


N/A N/A 72% 70% 71% N/A N/A


73% 74% 73% 75% 76% 74%* 72%*


77%* 72%* 73%* 68%* 77% 79%* 80%*

N/A – Not Available *Includes all women regardless of age.

40%

15%

58%

37%42%

37%

48%

53%

42%

36%

55%

61%

51%

43%

61%

52%

61% 60%55% 57%

36%

46%

29%

21%

44%

33%

44%

54%49%

41%

0%

25%

50%

75%

100%

Lucas 2020 Under 40 40 & Older Income<$25K

Income>$25K


Latino Lucas 2014 Lucas 2017

Lucas County Women's Health Exams Within the Past Year


Five Minutes for Women’s Health

The CDC released five things women can do that can go a long way to improve or maintain good health. In five minutes or less women can:

— Learn about the number one killer of women: Heart disease is the leading cause of death for women in the U.S. Learn the symptoms of heart attack and stroke.

— Schedule a check-up: Regular check-ups are important. Schedule an appointment with your provider to discuss screenings and exams you need and when they are needed.

— Protect your skin from the sun: Skin cancer is the most common cancers among women n the U.S. Protect your skin and wear a broad spectrum sunscreen before you go outside.

— Find an HIV, STD, and hepatitis testing site near you: Untreated STDs can have long term consequences for women.

— Take folic acid before and during pregnancy: Folic acid can help prevent certain birth defects. If a woman has enough folic acid in her body before/during pregnancy, her baby may be less likely to have certain birth defects.

(Source: CDC, Health Equity, Five Minutes for Women’s Health, Updated on September 12, 2017)

MEN’S HEALTH | 68

Health Care Access: Men’s Health

Key Findings More than half (58%) of Lucas County men had a digital rectal exam in their lifetime, and 17% had one in the past year. More than two-fifths (44%) of men had been diagnosed with high blood pressure, 27% had high blood cholesterol, and 14% were identified as smokers, which, along with obesity (36%), all of which are known risk factors for cardiovascular diseases.

Men’s Health Screenings

• More than half (58%) of Lucas County men had a digital rectal exam in their lifetime, and 17% had one in the past year.

Men’s Health Concerns

• Major risk factors for cardiovascular disease include

smoking, obesity, high blood cholesterol, high blood pressure, physical inactivity, and diabetes.

• In 2020, the health assessment identified that: — 77% of men were overweight or obese (2018 BRFSS

reports 73% for Ohio and 71% for U.S.) 44% were diagnosed with high blood pressure (2018 BRFSS reports 37% for Ohio and 35% for U.S.) 27% were diagnosed with high blood cholesterol (2018 BRFSS reports 34% for Ohio and 35% for U.S.) — 14% had been diagnosed with diabetes (2018 BRFSS reports 12% for Ohio and 12% for U.S.) — 14% of all men were current smokers (2018 BRFSS reports 22% for Ohio and 18% for U.S.)


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Had a digital rectal exam within the past year

30% 26% 22% 18% 17% N/A N/A


Ohio Male Leading Causes of Death, 2016 – 2018

Total Male Deaths: 185,146

1. Heart Diseases (24% of all deaths) 2. Cancers (22%) 3. Accidents, Unintentional Injuries (9%) 4. Chronic Lower Respiratory Diseases (6%) 5. Stroke (4%)


Lucas County Male Leading Causes of Death, 2016 – 2018

Total Male Deaths: 7,125

1. Heart Diseases (26% of all deaths) 2. Cancers (21%) 3. Accidents, Unintentional Injuries (9%) 4. Chronic Lower Respiratory Diseases (6%) 5. Stroke (4%) (Source: Ohio Public Health Data Warehouse, 2016-2018)

What is Prostate Cancer Screening?

Cancer screening means looking for cancer before it causes symptoms. The goal of screening is to find cancer early that may spread if not treated. There is no standard test to screen for prostate cancer. Two different tests are commonly used to screen for prostate cancer. Talk to your doctor about the below screenings if you are thinking about being screened:

• A blood test called a prostate specific antigen (PSA) test o PSA is a substance the prostate makes. This test measures the level of PSA a man’s blood. The PSA

level may be high if a man has prostate cancer and for many reasons, such as having an enlarged prostate, a prostate infection, or taking certain medicines.

• A digital rectal examination o A digital rectal exam is when a health care provide inserts a gloved, lubricated finger into a man’s

rectum to feel the prostate for anything abnormal, such as cancer.

(Source: CDC, Cancer Prevention and Control, Prostate Cancer Awareness, August 20, 2020)

MEN’S HEALTH | 69

The following graphs show the percentage of Lucas County males who had digital rectal exams in the past year. Examples of how to interpret the information include: 17% of Lucas County males had a digital rectal exam within the past year, including 29% of those ages 50 and older and 18% of those with annual incomes more than $25,000.


17%

10%

29%

18% 18% 18%

22%

5%

26%

22%

18%

0%

10%

20%

30%

40%

Lucas 2020 Under 50 50 & Older Income<25K

Income$25K Plus


Latino Lucas 2011 Lucas 2014 Lucas 2017

Lucas County Men's Digital Rectal Exams Within the Past Year

Men and Heart Disease*

Heart disease is the leading cause of death for men in the United States, killing 347,879 men in 2017—that’s about 1 in every 4 male deaths.

• About 1 in 13 (7.7%) white men and 1 in 14 (7.1%) Black men have coronary heart disease. About 1 in 17 (5.9%) Hispanic men have coronary heart disease.

• Half of the men who die suddenly of coronary heart disease had no previous symptoms. Even if you have no symptoms, you may still be at risk for heart disease.

High blood pressure, high LDL (low-density lipoprotein) cholesterol, and smoking are key risk factors for heart disease. About half of Americans (47%) have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including the following:

• Diabetes • Overweight and obesity • Unhealthy diet • Physical inactivity • Excessive alcohol use

To reduce your chances of getting heart disease, it’s important to do the following:

• Know your blood pressure. Having uncontrolled blood pressure can result in heart disease. High blood pressure has no symptoms so it’s important to have your blood pressure checked regularly.

• Talk to your health care provider about whether you should be tested for diabetes. Having diabetes raises your risk of heart disease.

• Quit smoking. If you don’t smoke, don’t start. If you do smoke, learn ways to quit. • Discuss checking your cholesterol and triglyceride levels with your health care provider. • Make healthy food. Being overweight or obesity raises your risk of heart disease. • Limit alcohol intake to one drink a day. • Lower your stress level and find healthy ways to cope with stress.

*The term heart disease refers to several types of heart conditions, including coronary artery disease and heart attack. (Source: CDC, Men and Heart Disease, Updated January 31, 2020)

ORAL HEALTH | 70

Health Care Access: Oral Health Key Findings Sixty-four percent (64%) of Lucas County adults visited a dentist or dental clinic in the past year. One-fifth (20%) of adults did not see a dentist in the past year due to cost.

Oral Health • In the past year, 64% of Lucas County adults had visited a dentist or dental clinic, decreasing to 39% of those

with annual incomes less than $25,000.

• Sixty-seven percent (67%) of Lucas County adults with dental insurance had been to the dentist in the past year, compared to 22% of those without dental insurance.

• Adults reported the following reasons for not visiting a dentist in the last year: — Cost (20%) — No reason to go/had not thought of it (19%) — Fear, apprehension, nervousness, pain, and dislike going (15%) — Had dentures (12%) — Did not have/know a dentist (6%) — Their dentist did not accept their insurance (3%) — Could not find a dentist taking Medicaid patients (2%) — Could not get into a dentist (1%) — Transportation (1%) — Other reasons (8%)

• Lucas County adults completed the following oral health habits daily: brushed their teeth (94%), used mouth

wash (48%), and flossed their teeth (48%).

• Lucas County adults had the following oral health issues: pain (9%), difficulty eating/chewing (7%), oral bleeding (7%), problems with dentures (4%), loose teeth (4%), no teeth (4%), skipped meals due to pain (2%), missed work due to mouth pain (2%), and other (9%). Eleven percent (11%) of adults reported experiencing two or more oral health issues.

Adult Oral Health Within

the Past Year

Within the Past

Two Years

Within the Past

Five Years

Five or More years

Never

Time Since Last Visit to Dentist/Dental Clinic

Males 65% 10% 8% 11% 1%

Females 63% 18% 9% 8% 1%

Total 64% 15% 9% 9% 1%

During the past year, 64% of adults or approximately 209,098 Lucas County adults visited a dentist or dental clinic.

ORAL HEALTH | 71

The following graph shows the percentage of Lucas County adults who visited a dentist or dental clinic in the past year. Examples of how to interpret the information include: 64% of Lucas County adults had been to the dentist or dental clinic in the past year, including 65% of males and 39% of those with annual incomes less than $25,000.



County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Visited a dentist or a dental clinic (within the past year)

66% 68% 66% 66% 64% 67%* 68%*

*2018 BRFSS Data

Facts About Adult Oral Health

• The baby boomer generation is the first where most people will keep their natural teeth over their entire lifetime. This is largely because of the benefits of water fluoridation and fluoride toothpaste. However, threats to oral health, including tooth loss, continue throughout life.

• The major risks for tooth loss are tooth decay and gum disease that may increase with age because of problems with saliva production; receding gums that expose “softer” root surfaces to decay-causing bacteria; or difficulties flossing and brushing because of poor vision, cognitive problems, chronic disease, and physical limitations.

• Although more adults are keeping their teeth, many continue to need treatment for dental problems. This need is even greater for members of some racial and ethnic groups—about three in four (75%) Hispanics and non-Hispanic Black adults have an unmet need for dental treatment, as do people who are poor. These individuals are also more likely to report having poor oral health.

• In addition, some adults may have difficulty accessing dental treatment. For every adult aged 19 years or older without medical insurance, there are three who don’t have dental insurance.

• Oral health problems include the following: untreated tooth decay, gum disease, tooth loss, oral cancer, and chronic diseases such as arthritis, heart disease, and strokes.

(Source: Centers for Disease Control and Prevention, Division of Oral Health, Adult Oral Health, December 19, 2019)

64% 65% 63% 61%66%

61%

39%

72% 71%

44%

58%

68% 66% 66%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Visiting a Dentist or Dental Clinic in the Past Year

HEALTH STATUS PERCEPTIONS | 72

Health Behaviors: Health Status Perceptions Key Findings In 2020, 45% of Lucas County adults rated their health status as excellent or very good. Conversely, 17% of adults described their health as fair or poor, increasing to 34% of those with annual incomes less than $25,000. General Health Status • Forty-five percent (45%) of Lucas County adults rated their health as excellent or very good. Lucas County

adults with higher annual incomes (55%) were most likely to rate their health as excellent or very good, compared to 20% of those with annual incomes less than $25,000.

• Seventeen percent (17%) of adults rated their health as fair or poor. • Lucas County adults were most likely to rate their health as fair or poor if they:

— Had been diagnosed with diabetes (37%) — Had an annual household income less than $25,000 (34%) — Were 65 years of age or older (26%) — Had high blood pressure (26%)

• Thiry-five percent (35%) of adults reported that poor mental or physical health kept them from doing usual

activities such as self-care, work, or recreation. The following graph shows the percentage of Lucas County adults who described their personal health status as excellent/very good, good, and fair/poor. Examples of how to interpret the information include: 45% of Lucas County adults, 43% of those under age 30, and 36% of those ages 65 and older rated their health as excellent or very good.

*Respondents were asked: “Would you say that in general your health is excellent, very good, good, fair or poor?” Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

17% of adults, or approximately 55,542 of Lucas County adults rated their general health as fair or poor.

45% 47% 45% 43% 49%36%

20%

55% 50%36%

45% 48% 45% 49%

38% 39% 37%50% 34%

38%

46%

35%37%

39%

40% 34% 37%37%

17% 14% 18%7%

17%26%

34%

10% 13%25%

15% 18% 18% 14%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Health Perceptions*



Physical Health Status

• One-quarter (25%) of Lucas County adults rated their physical health as not good on four or more days in the previous month.

• Lucas County adults reported their physical health as not good on an average of 4.2 days in the previous

month. • Lucas County adults were most likely to rate their physical health as not good (on four or more days during the

past month) if they: — Had an annual household income less than $25,000 (46%) — Were 65 years of age or older (31%) — Were female (26%)

Mental Health Status

• More than one-third (34%) of Lucas County adults rated their mental health as not good on four or more days in the previous month.

• Lucas County adults reported their mental health as not good on an average of 5.5 days in the previous month. • Lucas County adults were most likely to rate their mental health as not good (on four or more days during the

past month) if they: — Were under the age of 30 (62%) — Had an annual household income less than $25,000 (51%) — Were female (41%)

The table shows the percentage of adults with poor physical and mental health in the past 30 days.

*Totals may not equal 100% as some respondents answered, “Don’t know.”

Health Status No Days 1-3 Days 4-5 Days 6-7 Days 8 or More Days

Physical Health Not Good in Past Month*

Males 47% 19% 6% 5% 14% Females 46% 20% 5% 5% 16%

Total 47% 20% 5% 5% 15% Mental Health Not Good in Past Month*

Males 53% 12% 6% 3% 21% Females 37% 18% 10% 2% 26%

Total 44% 15% 8% 2% 24%



‡2017 BRFSS as compiled by 2020 County Health Rankings * County Health Rankings


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Rated health as excellent or very good 51% 48% 45% 49% 45% 48% 51% Rated general health as fair or poor 14% 18% 18% 14% 17% 19% 18% Rated mental health as not good on four or more days (in the past month)

26% 25% 26% 37% 34% N/A N/A


N/A N/A 22% 24% 25% N/A N/A

Average number of days that mental health was not good (in the past month)*

N/A N/A 4.3 6.0 5.5 4.6‡ 4.0‡

Average number of days that physical health not good (in the past month)*

N/A N/A 4.0 4.8 4.2 3.9‡ 3.8‡


N/A N/A N/A 35% 35% N/A N/A

WEIGHT STATUS | 75

Health Behaviors: Adult Weight Status

Key Findings Nearly three-fourths (72%) of Lucas County adults were overweight (34%) or obese (38%) based on body mass index (BMI). One-fourth (25%) of adults did not participate in any physical activity in the past week, including 3% who were unable to exercise.

Adult Weight Status

• Nearly three-fourths (72%) of Lucas County adults were either overweight (34%) or obese (38%) by body mass index (BMI), putting them at elevated risk for developing a variety of diseases.

• More than half (51%) of adults were trying to lose weight, 29% were trying to maintain their current weight or keep from gaining weight, and 3% were trying to gain weight.

• Lucas County adults did the following to lose weight or keep from gaining weight in the past month: ate less food, fewer calories, or foods low in fat (46%); exercised (45%); drank more water (42%); ate a low-carb diet (16%); took diet pills, powders or liquids without a doctor’s advice (3%); used a weight loss program (3%); smoked cigarettes (3%); went without eating 24 or more hours (2%); vomited after eating (2%); health coaching (2%); took prescribed medications (1%); took laxatives (1%); had bariatric surgery (<1%); participated in a prescribed dietary or fitness program (<1%); and other (3%).

• Lucas County adults spent an average of 3.0 hours watching TV, 2.1 hours on their cell phone, 1.4 hours on a

PC/tablet, and 0.4 hours playing video games on an average day of the week. The following graph shows the percentage of Lucas County adults who are overweight or obese by body mass index (BMI). Examples of how to interpret the information include: 27% of all Lucas County adults were classified as normal weight, 34% were overweight, and 38% were obese.

*Percentages may not equal 100% due to the exclusion of data for those who were classified as underweight. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

38% of Lucas County adults or approximately 124,152 adults were obese.

27% 22%31%

38%24% 22% 21%

28% 32%21% 17%

28% 29% 25%

34% 41% 28%

31%

36% 38% 34%33%

34%

34%29%

36% 34% 38%

38% 36% 39% 24% 39% 39% 43%38% 32%

45%51%

35% 36% 36%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult BMI Classifications*


WEIGHT STATUS | 76

Physical Activity

• In Lucas County, 55% of adults engaged in some type of physical activity or exercise for at least 30 minutes 3 or more days per week. Twenty-eight percent (28%) of adults exercised 5 or more days per week. One fourth (25%) of adults did not participate in any physical activity in the past week, including 3% who were unable to exercise.

• Lucas County adults spent the most time doing the following physical activities in the past year: walking (28%), running/jogging (7%), exercise machines (5%), strength training (5%), occupational exercise (4%), group exercise classes (3%), cycling (2%), swimming (<1%), exercise videos (<1%) and other (5%). Twenty-eight percent (28%) of adults engaged in multiple types of exercise.

• Adults reported the following would help them use community parks, bike trails, and walking paths more frequently: more accessible parks, bike trails, and walking paths (31%); designated safe routes (27%); improvements to existing parks, trails, and paths (22%); and more public events and programs involving parks, trails, and paths (20%).

• Adults reported the following reasons for not exercising: — Time (25%) — Self-motivation/will power (20%) — Laziness (18%) — Weather (16%) — Too tired (16%) — Do not like to exercise (10%) — Choose not to exercise (10%) — Could not afford a gym membership (6%) — Ill or physically unable (5%) — Poorly maintained/no sidewalks (4%) — Pain or discomfort (4%) — No exercise partner (4%) — Neighborhood safety (3%) — No walking, biking trails, or parks (3%) — Afraid of injury (3%) — No child care (2%) — Do not know what activity to do (2%) — Too expensive (1%) — No transportation to a gym or other exercise opportunity (1%) — No gym available (1%) — Doctor advised them not to exercise (1%) — Lack of opportunities for those with physical impairments or challenges (1%) — Other (5%)

Adult Comparisons

Lucas County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019



33% 35% 36% 36% 38% 35% 32%

WEIGHT STATUS | 77

Nutrition The table below indicates the number of servings of fruit, vegetables, sugar-sweetened beverages, and caffeinated beverages Lucas County adults consumed daily.

5 or more servings

daily

3-4 servings

daily

1-2 Servings

daily

0 servings

daily

Fruit 1% 9% 77% 13%

Vegetables 3% 18% 73% 6%

Sugar-sweetened beverages 5% 9% 35% 51%

Caffeinated beverages 7% 21% 46% 26%

• In 2020, 37% of adults ate 1 to 2 servings of fruits and/or vegetables per day, 39% ate 3 to 4 servings per day,

and 20% ate 5 or more servings per day. Four percent (4%) of adults ate no servings of fruits and vegetables per day.

Summary of the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity

1. Achieve and maintain a healthy weight throughout life • Be as lean as possible throughout life without being underweight. • Avoid excess weight gain at all ages. For those who are overweight or obese, losing even a small

amount of weight has health benefits and is a good place to start. • Get regular physical activity and limit intake of high calorie foods and drinks as keys to help maintain

a healthy weight. 2. Be physically active

• Get at least 150-300 minutes of moderate intensity or 75-150 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.

• Limit sedentary behavior such as sitting, lying down, watching TV, and other forms of screen-based entertainment.

• Doing some physical activity above usual activities, no matter what one’s level of activity, can have many health benefits.

3. Eat a healthy diet, with an emphasis on plant foods • Choose foods and drinks in amounts that help you get to and maintain a healthy weight. • Eat a variety of vegetables and whole fruits. • Choose whole grains instead of refined grain products.

(Source: American Cancer Society, Summary of the ACS Guidelines on Nutrition and Physical Activity, Updated on June 9, 2020)

WEIGHT STATUS | 78

• Lucas County adults reported they obtain their fresh fruits and vegetables from the following: — Large grocery store (such as Wal-Mart, Meijer, Kroger) (91%) — Farmers market (42%) — Local grocery store (such as Save-A-Lot) (26%) — Grow their own/garden (17%) — Dollar general/store (3%) — Food pantry (3%) — Group purchasing, community supported agriculture (CSA) (2%) — Corner/convenience stores (1%) — Community garden (1%) — Veggies mobile/mobile produce (1%) — Mail order food services (such as Blue Apron) (<1%) — Other (5%)

• Lucas County adults reported the following barriers to consuming fruits and vegetables: too expensive (10%), did not like the taste (4%), did not know how to prepare (3%), did not have access to fruits and vegetables (3%), no variety (1%), transportation (<1%), stores did not take EBT (<1%), and other barriers (4%).

• Lucas County adults reported the following reasons they chose the types of food they ate: — Taste/enjoyment (62%) — Healthiness of food (54%) — Cost (49%) — Ease of preparation/time (45%) — Food they were used to (33%) — Nutritional content (31%) — Calorie content (25%) — What their family prefers (24%) — Availability (23%) — If it is organic (12%) — Artificial sweetener content (8%) — If it is lactose free (7%) — If it is genetically modified (7%) — Other food sensitivities (6%) — Health care provider’s advice (5%) — If it is gluten free (4%) — Limitations due to dental issues (3%) — Availability at food panty (3%) — Limitations set by WIC (1%) — Other reasons (4%)

Improving Fruit and Vegetable Access

Poor diet quality is a leading risk factor associated with death and disability in the United States. Eating a diet rich in fruits and vegetables as part of an overall healthy diet can help protect against a number of serious and costly chronic diseases, including heart disease, type 2 diabetes, some cancers, and obesity. Fruits and vegetables also provide important vitamins and minerals that help the human body work as it should and fight off illness and disease.

• The 2015–2020 Dietary Guidelines for Americans recommends that adults consume 1.5–2 cups of fruits and 2–3 cups of vegetables per day.

• Despite these recommendations, recent data show low consumption. Only 1 in 10 US adults eat the recommended amount of fruits or vegetables each day.

• Income-related disparities exist, with 7% of adults who live at or below the poverty level meeting the daily vegetable recommendation, compared to 11.4% of adults with the highest household incomes.

(Source: CDC, State Indicator Report on Fruits and Vegetables, Updated June 2018)

WEIGHT STATUS | 79

The Food Environment Index measures the quality of the food environment in a county on a scale from zero to 10 (zero being the worst value in the nation, and 10 being the best). The two variables used to determine the measure are limited access to healthy foods and food insecurity. • The food environment index in Lucas County is 6.9. • The food environment index in Ohio is 6.7.

(Source: USDA Food Environment Atlas, as compiled by 2020 County Health Rankings)

Lucas County had a food index measure of:

6.9

TOBACCO USE | 80

Health Behaviors: Adult Tobacco Use Key Findings In 2020, 15% of Lucas County adults were current smokers, and 25% were considered former smokers. Four percent (4%) of adults used e-cigarettes or vapes in the past year. Seventy-six percent (76%) of adults reported they would support an ordinance to ban smoking in a vehicle with a minor present.

Adult Tobacco Use Behaviors • Fifteen percent (15%) of Lucas County adults were current smokers (those who indicated smoking at least 100

cigarettes in their lifetime and currently smoked some or all days). • One-quarter (25%) of adults indicated that they were former smokers (smoked 100 cigarettes in their lifetime

and now do not smoke). • Lucas County adult smokers were more likely to have:

— Annual incomes less than $25,000 (27%) — Been widowed (22%) — Been ages 30-64 (16%) — Been female (16%)

• Lucas County adults used the following tobacco products in the past year: cigarettes (19%); e-cigarette/vapes

(4%); cigars (4%); chewing tobacco, snuff, or snus (2%); little cigars (2%); cigarillos (2%); hookah (1%); pipes (1%); and dissolvable tobacco (<1%).

• Over half (56%) of current smokers responded that they had stopped smoking for at least one day in the past year because they were trying to quit smoking.

• Lucas County adults had the following rules/practices about smoking tobacco in their home: allowed only in certain rooms (6%), not allowed with children around (35%), and allowed anywhere (10%). Lucas County adults had the following rules/practices about smoking tobacco in their car: allowed inside their car (7%), never allowed (77%), allowed only when one or more windows are open (8%), and not allowed with children around (9%).

• Lucas County adults had the following rules/practices about using e-cigarettes/vapes in their home: never

allowed (77%), allowed only in certain rooms (3%), not allowed with children around (29%), and allowed anywhere (13%). Lucas County adults had the following rules/practices about using e-cigarettes/vapes in their car: allowed inside their car (7%), never allowed (71%), allowed only when one or more windows are open (3%), and not allowed with children around (7%).

• Lucas County adults reported they would support an ordinance to ban smoking in the following places:

— Vehicle with a minor present (76%) — Multi-unit housing (57%) — College/university campuses (57%) — Parks or ball fields (56%) — Rental homes (52%) — Fairgrounds (51%)

• Twenty percent (20%) of Lucas County adults reported they would not support an ordinance to ban smoking anywhere.

15% of Lucas County adults, or approximately 49,007 adults were current smokers.

TOBACCO USE | 81

• Lucas County adults indicated e-cigarette vapor is harmful to the following: themselves (72%), an unborn child (66%), others (65%), and children (62%).

• Three percent (3%) of Lucas County adults did not believe e-cigarette vapor was harmful to anyone.


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Current smoker (smoked on some or all days)

23% 24% 19% 14% 15% 21% 16%


25% 23% 25% 23% 25% 24% 25%

Tried to quit smoking in the past year 85% 75% 74% 50% 56% N/A N/A

Used chewing tobacco or snuff in the past year

N/A N/A 3% 3% 2% N/A N/A


E-Cigarette Health Effects

• Most e-cigarettes contain nicotine, which has known health effects. Nicotine is highly addictive. Nicotine is toxic to developing fetuses. Nicotine can harm adolescent brain development, which continues into the early-to-mid-20s. Nicotine is a health danger for pregnant women and their developing babies.

• The e-cigarette aerosol that users breathe from the device and exhale can contain both harmful and potentially harmful substances. This includes nicotine; ultrafine particles that can be inhaled deep into the lungs; flavoring such as

diacetyl, a chemical linked to a serious lung disease; volatile organic compounds; cancer-causing chemicals; and heavy metals such as nickel, tin, and lead.

It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.

Additionally, this includes cancer-causing chemicals and tiny particles that reach deep into lungs. However, e-cigarette aerosol generally contains fewer harmful chemicals than smoke from burned tobacco products.

• E-cigarettes can cause unintended injuries. Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious

injuries. Most explosions happened when the e-cigarette batteries were being charged. The Food and Drug Administration (FDA) collects data to help address this issue. In addition, acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing,

breathing, or absorbing e-cigarette liquid through their skin or eyes. • E-cigarettes are less harmful than regular cigarettes, but that doesn’t mean they are safe.

E-cigarette aerosol generally contains fewer toxic chemicals than the deadly mix of 7,000 chemicals in smoke from regular cigarettes. However, e-cigarette aerosol is not harmless. It can contain harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds, and cancer-causing agents.

E-cigarettes are not currently approved by the FDA as a smoking cessation aid. The U.S. Preventive Services Task Force, a group of health experts that makes recommendations about preventive health care, has concluded that evidence is insufficient to recommend e-cigarettes for smoking cessation in adults, including pregnant women. However, according to the CDC, e-cigarettes may help non-pregnant adult smokers if used as a complete substitute for all cigarettes and other smoked tobacco products.

(Source: CDC, Smoking & Tobacco Use, About Electronic Cigarettes (E-Cigarettes), updated September 9, 2020)

TOBACCO USE | 82

The following graph shows Lucas County adults’ smoking behaviors. Examples of how to interpret the information include: 15% of all Lucas County adults were current smokers, 25% of all adults were former smokers, and 60% had never smoked.

Respondents were asked: “Have you smoked at least 100 cigarettes in your entire life? If yes, do you now smoke cigarettes every day, some days or not at all?”


15% 14% 16%10%

16%10%

27%

11% 16% 21%14%

24% 19% 14%

25% 25% 25%

10%

27% 39%

26%

26%26% 18% 30%

23%25%

23%

60% 61% 59%

80%

57%51% 47%

63% 58% 61% 56% 53% 56%63%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Smoking Behaviors*


Cost of Smoking

Smoking leads to disease and disability, and it harms nearly every organ of the body. • More than 16 million Americans are living with a disease caused by smoking. • For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. • Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary

disease (COPD), which includes emphysema and chronic bronchitis. • Smoking also increases the risk for tuberculosis, certain eye diseases, and problems of the immune system,

including rheumatoid arthritis. • Smoking is a known cause of erectile dysfunction in males.

Smoking is the leading cause of preventable death. • Worldwide, tobacco use causes more than 7 million deaths per year. If the pattern of smoking all over the

globe doesn’t change, more than 8 million people a year will die from diseases related to tobacco use by 2030.

• Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.

• On average, smokers die 10 years earlier than nonsmokers. • If smoking continues at the current rate among U.S. youth, 5.6 million of today’s Americans younger than 18

years of age are expected to die prematurely from a smoking-related illness. This represents about one in every 13 Americans aged 17 years or younger who are alive today.

Smoking costs the United States billions of dollars each year. Total economic cost of smoking is more than $300 billion a year, including the following costs:

• Nearly $170 billion in direct medical care for adults. • More than $156 billion in lost productivity due to premature death and exposure to secondhand smoke.

(Source: CDC, Smoking & Tobacco Use, Fast Facts, Updated May 21, 2020)

ALCOHOL CONSUMPTION | 83

Health Behaviors: Adult Alcohol Consumption Key Findings Sixty percent (60%) of Lucas County adults had at least one alcoholic drink in the past month. Twenty-two percent (22%) of adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on one occasion in the last month and would be considered binge drinkers. Adult Alcohol Consumption • Sixty percent (60%) of Lucas County adults had at least one alcoholic drink in the past month, increasing to 71%

of males and those with annual incomes more than $25,000. • Of those who drank, adults consumed 3.5 drinks on average, increasing to 4.3 drinks for males and 4.2 drinks for

those with annual incomes less than $25,000. • More than one-fifth (22%) of Lucas County adults reported they had five or more alcoholic drinks (for males) or

four or more drinks (for females) on one occasion in the last month and would be considered binge drinkers. Of those who drank in the past month, 42% had at least one episode of binge drinking.

• Twelve percent (12%) of adults reported driving after having perhaps too much alcohol to drink in the past

month, increasing to 14% of those ages 30-64.

• Lucas County adults reported they or a family member experienced the following during the past 6 months: — Drank more than they expected (9%) — Drove a vehicle or other equipment after having any alcoholic beverage (6%) — Continued to drink despite problems caused by drinking (5%) — Used prescription drugs while drinking (5%) — Spent a lot of time drinking (4%) — Had to drink more to get same effect (4%) — Tried to quit or cut down but couldn’t (3%) — Drank to ease withdrawal symptoms (3%) — Placed themselves or their family in harm (2%) — Gave up other activities to drink (2%) — Had legal problems (1%) — Failed to fulfill duties at work, home, or school (1%)

• Five percent (5%) of Lucas County adults had used a program or service to help with an alcohol problem for

themselves or a loved one. Reasons for not using a program or service to help with an alcohol problem included the following: had not thought of it (6%), did not want to miss work (2%), stigma of seeking alcohol services (2%), fear (2%), could not afford to go (1%), transportation (1%), programs are always full (1%), unable to find a program (1%), did not have any openings (wait-listed) (1%), did not know how to find a program (1%), a program was not available (1%), did not want to get in trouble (<1%), and other (9%). Eighty-two percent (82%) of adults indicated that they did not need a program or service to help with an alcohol problem for themselves or a loved one.

22% of Lucas County adults, or approximately 71,877 adults were considered binge drinkers.


N/A – Not Available *2018 BRFSS Data


County 2007

Lucas County 2011

Lucas County 2014

Lucas County

2017

Lucas County 2020

Ohio 2019

U.S. 2019


57% 57% 54% 65% 60% 53% 54%


18% 23% 21% 24% 22% 18% 17%


N/A N/A N/A 8% 12% 4%* 3%*

Drinking and Driving

Drinking and Driving Statistics in the United States

• Driving after drinking is deadly, yet it still happens across the Unites States. While impaired, someone could get arrested or worse, be involved in a traffic crash that cause injury or death.

• Approximately one-third of all traffic crash fatalities in the United States involve drunk drivers (with blood alcohol concentration of .08 grams of alcohol per deciliter (g/dL) or higher). In 2018, there were 10,511 people killed in these preventable crashes.

• On average, over the 10-year period from 2009-2018, more than 10,000 people died every year in drunk-driving crashes.

• In every state, it is illegal to drive with a blood alcohol concentration of .08 or higher, yet, in 2018, one person was killed in a drunk driving crash every 50 minutes in the United States.

• Men are more likely to be driving drunk in fatal crashes. In 2018, 21% of men were drunk in these crashes compared to 14% of women.

How alcohol affects driving ability

• As alcohol levels rise in a person’s system, the negative effects on the central nervous system increase. • Alcohol is absorbed directly through the walls of the stomach and small intestine. It then passes into the

bloodstream, where it accumulates until it is metabolized by the liver. This is called blood alcohol concentration, or BAC.

• At a BAC level of .08 grams of alcohol per deciliter (g/dL) of blood, the risk for crash increases exponentially. Because of this risk, it’s illegal in all 50 states to drive with a BAC of .08 or higher.

• In 2018, there were 1,878 people killed in alcohol-related crashed where drivers had BACs below the legal threshold for drunk driving (i.e., BACs below .08 g/dL)

(Source: National Highway Traffic Safety Administration, Drunk Driving, Retrieved September 1, 2020).


The following graphs show the percentage of Lucas County adults consuming alcohol and the amount consumed on average in the past month. Examples of how to interpret the information shown on the first graph include: 40% of all Lucas County adults did not drink alcohol in the past month, including 41% of females and 50% of those ages 65 and older.

*Percentages may not equal 100% as some respondents answered, “Don’t know.”

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

3.5

4.3

2.8

3.83.3

3.84.2

3.4 3.3

4.14.4

3.0

4.0

2.8

0

2

4

6

8

10

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Adults' Average Number of Drinks Consumed Per Drinking Occasion

40% 39% 41% 37% 41%50%

64%

29% 33%

51%45% 43% 41%

35%

16%12%

20%17%

18%11%

14%

18%17%

15%

10% 18%16% 23%

43%47%

39%47% 39% 37%

20%

52% 50%31%

43%39%

39% 42%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Average Number of Days Drinking Alcohol in the Past Month*


DRUG USE | 86

Health Behaviors: Adult Drug Use

Key Findings In 2020, 16% of Lucas County adults reported they and/or an immediate family member or someone in their household used recreational marijuana during the past 6 months. Eight percent (8%) of adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past 6 months.

Adult Drug Use

• Lucas County adults reported that they and/or an immediate family member/someone in their household used the following in the past 6 months: — Recreational marijuana or hashish (16%) — Wax, oil, or edibles with THC (13%) — Medical marijuana (9%) — Amphetamines, methamphetamine or speed (5%) — Cocaine, crack, or coca leaves (2%) — Bath salts (2%) — LSD, mescaline, peyote, psilocybin, DMY, or mushrooms (2%) — Inappropriate use of over-the-counter medications (2%) — Heroin/fentanyl (2%) — Ecstasy, E, or GHB (2%) — Inhalants (1%) — Synthetic marijuana/k2 (1%)

• Seven percent (7%) of Lucas County adults reported using recreational marijuana or hashish in the past 6 months.

• Lucas County adults reported that they and/or an immediate family member/someone in their household took

the following medications not prescribed to them to feel good, high and/or more active or alert during the past 6 months: — Tranquilizers such as Valium or Xanax (6%) — Steroids (5%) — Codeine, Demerol, Morphine, Percocet, Dilaudid, or Fentanyl (5%) — Ritalin, Adderall, Concerta, or other ADHD medication (5%) — OxyContin (4%) — Tramadol/Ultram (4%) — Vicodin (4%) — Suboxone or Methadone (2%) — Neurontin (2%)

• Three percent (3%) of Lucas County adults reported being prescribed opioid based medication and had

trouble stopping. • As a result of using drugs, Lucas County adults indicated they or someone in their household experienced

the following: failed a drug screen (2%), regularly failed to fulfill obligations at work or home (2%), had legal problems (1%), were placed in dangerous situations (1%), and overdosed and required EMS/hospitalization (<1%).

• Two percent (2%) of Lucas County adults had used a program or service to help with a drug problem for

themselves or a loved one. Reasons for not using a program or service to help with a drug problem included the following: had not thought of it (3%), insurance did not cover it (1%), did not want to miss work (1%), did not have any openings (wait-listed) (1%), transportation (<1%), fear (<1%), could not afford to go (<1%), wait time (<1%), a program was not available (<1%), stigma of seeking drug services (<1%), did not want to get in trouble (<1%), and other (4%). Ninety-two percent (92%) of adults indicated that they did not need a program or service to help with a drug problem for themselves or a loved one.

DRUG USE | 87


The following graphs indicate adult recreational marijuana use and prescription drug use in the past 6 months. Examples of how to interpret the information on the first graph include: 7% of Lucas County adults used recreational marijuana in the past 6 months, including 17% of those ages 30 and under and 8% of those with annual incomes of $25,000 or more.

*Does not include wax or oil with THC edibles.

Notes for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Adults who used marijuana in the past 6 months

9% 11% 10% 12% 7% N/A N/A

Adults who misused prescription drugs in the past 6 months

6% 8% 10% 6% 8% N/A N/A

Adults who used heroin in the past 6 months

<1% 1% <1% <1% <1% N/A N/A

8% 8%7%

0%

11%

4%

13%

6%7%

9%

6%

8%

10%

6%

0%

5%

10%

15%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Medication Misuse in Past 6 Months

7% 7% 8%

17%

6%

2%

6%8% 8%

6% 7%

11% 10%12%

0%

5%

10%

15%

20%

25%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Recreational Marijuana Use in Past 6 Months

DRUG USE | 88

26.9 28.5

39.5 38.340.8

23.4

28.6

37.9

45.5

35.5

0

10

20

30

40

50

2014 2015 2016 2017 2018

Per

100

,000

Po

pu

lati

on

Lucas County and Ohio Age-Adjusted Unintentional Drug Overdose Death 2014-2018

Lucas County Ohio

The following graph shows the Lucas County and Ohio age-adjusted unintentional drug overdose deaths from 2014 to 2018.

The following graph shows the number of unintentional drug overdose deaths from 2014 to 2018 in Lucas County.

(Source for graphs: Ohio Public Health Data Warehouse, 2014-2018, Updated 7/17/20)

115 118

157 153166

0

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200

2014 2015 2016 2017 2018

Nu

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eath

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Lucas County Unintentional Drug Overdose Deaths, 2014-2018 Total Deaths=709

DRUG USE | 89

The following graphs are data from the Ohio Automated Prescription Reporting System (OARRS) indicating Lucas County and Ohio opiate and pain reliever doses per patient, as well as doses per capita.

(Source for graphs: Ohio Automated Rx Reporting System, Quarterly County Data)

282 279 270 271 259 257 253280 274 266 265 254 244 234

0

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2013 2014 2015 2016 2017 2018 2019

Do

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Lucas County and Ohio Number of Opiate and Pain Reliever Doses Per Patient, 2013-2018

Lucas County Ohio

72 7166 62

5447

42

67 65 61

55 49

41 36

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2013 2014 2015 2016 2017 2018 2019

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Lucas County and Ohio Number of Opiate and Pain Reliever Doses Per Capita, 2013-2018

Lucas County Ohio

DRUG USE | 90

The following graphs show Lucas County and Ohio quarterly opiate and pain reliever doses per capita and per patient.

(Source for graphs: Ohio’s Automated Rx Reporting System, 2018-2019)

11.9 11.5 11.6 11.5 11.0 10.9 10.4 10.3

10.3 10.0 10.0 10.0 9.6 9.3 8.9 8.9

0

5

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15

2018Quarter 1

2018Quarter 2

2018Quarter 3

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Lucas County and Ohio Number of Opioid Doses Per Capita, Quarterly from 2018-2019

Lucas County Ohio

138.1136.6

140.4 139.6137.2

134.8137.5 138.5

136.8135.5

137.2134.7 134.5

130.6132.1

130.9

120

125

130

135

140

145

2018Quarter 1

2018Quarter 2

2018Quarter 3

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Number of Opioid Doses Per Patient, Quarterly from 2018-2019

Lucas County Ohio

DRUG USE | 91

The following map illustrates the average age-adjusted unintentional drug overdose death rate per 100,000 population, by county, from 2013 to 2018.

(Source: Ohio Department of Health, 2018 Ohio Drug Overdose Data: General Findings)

SEXUAL BEHAVIOR | 92

Health Behaviors: Adult Sexual Behavior Key Findings Sixty-three percent (63%) of Lucas County adults had sexual intercourse in the past year. Seven percent (7%) of adults had more than one partner. Nine percent (9%) of Lucas County adults were forced to have any sort of unwanted sexual activity, increasing to 13% of females and 16% of those with annual incomes less than $25,000.

Adult Sexual Behavior

• Sixty-three percent (63%) of Lucas County adults had sexual intercourse in the past year.

• Seven percent (7%) of adults reported they had intercourse with more than one partner in the past year, increasing to 10% of those ages 30 and younger.

• Adults used the following methods of birth control: they or their partner is too old to get pregnant (23%); male

or female condoms (14%); female sterilization (tubes tied) (11%); birth control pills, any kind (11%); they or their partner is infertile (7%); hysterectomy (7%); withdrawal (6%); IUD (e.g., Mirena) (5%); gay or lesbian (4%); practicing abstinence (4%); contraceptive ring (e.g., NuvaRing) (2%); diaphragm, cervical cap, or sponge (2%); having sex at certain times (rhythm or natural family planning) (2%); foam, jelly, film or cream (1%); emergency contraception (1%); had ovaries or testicles removed (1%); contraceptive implant (e.g., Nexplanon) (1%); copper-bearing IUD (e.g., ParaGard) (1%); shots (e.g., Depo-Provera) (1%); and contraceptive patch (e.g., Xulane) (<1%).

• Eleven percent (11%) of Lucas County adults were not using any method of birth control, 4% were pregnant

and 4% were trying to get pregnant. • The following situations applied to Lucas County adults: had sex without a condom in the past year (24%); had

anal sex without a condom in the past year (6%); had sexual activity with someone of the same gender (4%); treated for a sexually transmitted disease (STD) in the past year (3%); had sex with someone they did not know (3%); had four or more sexual partners in the past year (2%); had sex with someone they met on social media (2%); engaged in sexual activity following alcohol or other drug use that they would not have done if sober (2%); tested positive for HPV (2%); tested positive for Hepatitis C (1%); were forced to have sex (1%); had unprotected sex because they could not afford birth control methods (<1%); injected any drug other than those prescribed (<1%); given/received food, drugs, shelter or money in exchange for sex in the past year (<1%); and tested positive for HIV (<1%).

• Nine percent (9%) of Lucas County adults were forced to have any sort of unwanted sexual activity, increasing to 13% of females and 16% of those with annual incomes less than $25,000. Sixteen percent (16%) of those who were forced to have sexual activity reported it.



County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Had more than one sexual partner in past year

10% 9% 8% 12% 7% N/A N/A


The following graph shows the number of sexual partners Lucas County adults had in the past year. Examples of how to interpret the information include: 56% of all Lucas County adults had one sexual partner in the past year, 7% had more than one partner, and 35% did not have a sexual partner.

Respondents were asked: “During the past year, with how many different people have you had sexual intercourse?”

*Totals may not equal 100% as some respondents answered, “Don’t know”. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey)

56% 58% 54%60% 62%

29%39%

64%56% 51%

65% 61% 60% 58%

7% 5% 8%10% 7%

2%

4%

7%

6%6%

10%9% 8% 12%

35% 33% 37%23%

31%

67% 51%

29%37%

34%

24% 30% 32%29%

0%

20%

40%

60%

80%

100%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25KPlus


Latino Lucas2011

Lucas2014

Lucas2017

Number of Sexual Partners in the Past Year*


Scope of the Problem: Sexual Violence

• 1 out of every 6 American women has been the victim of an attempted or completed rape in her lifetime (14.8% completed, 2.8% attempted).

• About 3% of American men—or 1 in 33—have experienced an attempted or completed rape in his lifetime. • From 2009-2013, Child Protective Services agencies substantiated, or found strong evidence to indicate

that, 63,000 children a year were victims of sexual abuse. • Most child victims are 12-17: 34% of victims of sexual assault and rape are younger than age 12, and 66% of

victims of sexual assault and rape are age 12-17. • Every 73 seconds another American is sexually assaulted. • The following number of people are victimized each year:

— 321,500 Americans age 12 and older were sexually assaulted or raped — 80,600 inmates were sexually assaulted or raped — 60,000 children were victims of “substantiated or indicated” sexual abuse — 18,900 military personnel experienced unwanted sexual contact

(Source: RAINN, Scope of the Problem: Statistics, 2019)


The following graphs show Lucas County chlamydia infection rates per 100,000 population. The graphs show:

• Lucas County chlamydia rates increased from 2014 to 2018. • The number of chlamydia cases in Lucas County increased from 2014 to 2018.

(Source: Ohio Department of Health, STD Surveillance Program, Data reported through 5/02/2019)

599.6677.2 705.5

767.5 787.0

468.4 489.9 521.8 526.8 543.4

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2014 2015 2016 2017 2018

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Chlamydia Annualized Rates for Lucas County and Ohio

Lucas County Ohio

2,606 2,937 3,051

3,307 3,391

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2014 2015 2016 2017 2018

Nu

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Annualized Count of Chlamydia Cases for Lucas County

Lucas County


The following graphs show Lucas County gonorrhea infection rates per 100,000 population. The graphs show:

• Lucas County gonorrhea rates increased significantly between 2015 and 2018. • Ohio gonorrhea rates steadily increased from 2014 to 2018.

(Source for graphs: Ohio Department of Health, STD Surveillance Program, Data Reported through 5/2/19)

180.2 169.7

255.0

393.8 418.4

138.3 143.1176.8

205.8 216.3

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Gonorrhea Annualized Rates for Lucas County and Ohio

Lucas County Ohio

783 736

1,103

1,697 1,803

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Annualized Count of Gonorrhea Cases for Lucas County

Lucas County


Pregnancy Outcomes Note: Pregnancy outcome data includes all births to both adults and adolescents.

• From 2014 to 2019, there was an average of 5,502 live births per year in Lucas County.

(Source: Ohio Public Health Data Warehouse 2014-2018, Updated 8/16/2020)

5,707

5,5665,634

5,457 5,417

5,231

4,500

5,000

5,500

6,000

2014 2015 2016 2017 2018 2019

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Lucas County Total Live Births

Unintended Pregnancy

• The concept of unintended pregnancy helps in understanding the fertility of populations and the unmet need for contraception, also known as birth control, and family planning. Most unintended pregnancies result from not using contraception or from not using it consistently or correctly.

• Unintended pregnancy is associated with an increased risk of problems for the mom and baby. If the mom was not planning to get pregnant, she may have unhealthy behaviors or delay getting health care during the pregnancy, which could affect the health of the baby. Therefore, it is important for all women of reproductive age to adopt healthy behaviors such as:

— Take folic acid — Maintain a healthy diet and weight — Be physically active regularly — Quit tobacco use — Refrain from excessive alcohol drinking — Abstain from alcohol if pregnant or planning to become pregnant — Take only medicines prescribed by your doctor — Talk to your health care provider about screening and proper management of chronic diseases — Visit your health care provider to receive recommended health care for your age, learn about

possible health risks, and discuss if or when you are considering becoming pregnant — Use effective contraception correctly and consistently if you are sexually active but choose to

delay or avoid pregnancy • The United States set family planning goals in Healthy People 2020 to improve pregnancy planning and

spacing, and to reduce the number of unintended pregnancies. Two ways to reach these goals are to increase:

o Access to contraception that includes the full range of methods, such as long-acting, and reversible forms like intrauterine devices and hormonal implants

o Correct and consistent use of contraception for sexually active women who choose to delay or avoid pregnancy

(Source: CDC, Reproductive Health, Unintended Pregnancy, Updated September 12, 2019)

MENTAL HEALTH | 97

Health Behaviors: Adult Mental Health Key Findings Five percent (5%) of Lucas County adults considered attempting suicide in the past year. Twenty-four percent (24%) of adults had a period of two or more weeks when they felt sad or hopeless nearly every day that they stopped doing usual activities in the past year. Adult Mental Health • During the past year, Lucas County adults experienced the following almost every day for two weeks or more in

a row: did not get enough sleep or rest (36%); had high stress (31%); felt worried, tense or anxious (30%); felt sad, blue or depressed (24%); stopped during some usual activities (14%); felt very healthy and full of energy (12%); and experienced an unusual increase or loss of appetite (11%).

• Five percent (5%) of Lucas County adults seriously considered attempting suicide in the past year.

• One percent (1%) of adults reported actually attempting suicide in the past year. • Lucas County adults reported they or someone in their household were diagnosed with or treated for the

following mental health issues in the past year: — Anxiety or emotional problems (26%) — Depression (25%) — Anxiety disorder (panic attacks, phobia,

obsessive-compulsive disorder) (19%) — Attention deficit disorder (ADD/ADHD) (11%) — Bipolar disorder (6%) — Post-traumatic stress disorder (PTSD) (6%) — Alcohol and/or illicit drug abuse (5%) — Other trauma (5%)

— Autism spectrum (4%) — Developmental disability (3%) — Eating disorder (3%) — Psychotic disorder (schizophrenia, schizoaffective

disorder) (3%) — Life adjustment disorder (2%) — Gambling problem (1%) — Other mental health disorder (6%)

• Twenty-three percent (23%) of adults indicated they or someone in their household have taken medication for

one or more mental health issues.

• Lucas County adults dealt with stress in the following ways: talked to someone they trust (48%), prayed/meditated (43%), listened to music (43%), exercised (41%), ate more or less than normal (39%), slept (35%), worked on a hobby (26%), worked (21%), drank alcohol (19%), smoked tobacco (10%), took it out on others (10%), used prescription drugs as prescribed (7%), called a professional (4%), used illegal drugs (3%), misused prescription drugs (1%), self-harmed (<1%), and other ways (12%).

• Sixteen percent (16%) of Lucas County adults had used a program or service for themselves or someone in their households to help with depression, anxiety, or emotional problems. The following prevented adults from using a program: had not thought of it (11%), did not know how to find a program (6%), other priorities (6%), could not afford to go (5%), co-pay/deductible too high (4%), fear (3%), stigma of seeking mental health services (3%), took too long to get in to see a doctor/health care provider (2%), could not find a mental health doctor or provider (2%), transportation (1%), could not get to the office or clinic (1%), and other reasons (4%). Fifty-six percent (56%) of adults indicated they did not need such a program.

5% of Lucas County adults, or approximately 16,336 adults seriously considered attempting suicide in the past year.

MENTAL HEALTH | 98

The graph below shows the number of suicide deaths by year in Lucas County.

(Source: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 3/27/20) Note: Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Considered attempting suicide in the past year

3% 3% 3% 2% 5% N/A N/A


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Lucas County Number of Suicide Deaths by Year2014-2018

Total Deaths =304

Suicide in the United States

Fatal Outcomes

• In 2018, suicide ranked as the 10th leading cause of death overall in the U.S. and ranked as the 2nd leading cause of death for those ages 15-34.

• In 2018, there was a total of 48,344 suicides, equating to an age-adjusted rate of 14.2 suicides per 100,000 people. Firearms accounted for half (50.5%) of these suicides, amounting to 24,432 suicides.

• On average, one person died due to suicide in the U.S. every 10.9 minutes. • Males have a higher rate of fatal suicide, with 3.6 suicide deaths for every female death by suicide.

Non-Fatal Outcomes

• In 2018, 1.2 million Americans attempted suicide. This equates to one suicide attempt every 26 seconds. • Females have a higher rate of attempting suicide, with three females attempting suicide for every male who

attempts suicide.

Survivors of Suicide Loss

• As much as 40-50% of the population have been exposed to suicide (those who knew someone personally who died by suicide) in their lifetime. The number of survivors of suicide loss in the U.S. is more than 5.4 million, or 1 out of every 61 Americans in 2018.

(Source: American Association of Suicidology, 2018 Facts and Statistics, Updated February 12, 2020)

MENTAL HEALTH | 99

The graphs below show the number of suicide deaths by age group and gender from 2014 to 2018 in Lucas County.

(Source for graphs: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 3/27/20) Note for graphs: Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.

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Lucas County Number of Suicide Deaths By Age Group, 2014-2018Total Deaths =304

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Lucas County Number of Suicide Deaths by Gender, 2014-2018Total Deaths=304

MENTAL HEALTH | 100

The graph below shows the number of suicide deaths by age group in Lucas County. The graph shows: • From 2010 to 2019, 19% of all Lucas County suicide deaths occurred among residents ages 35 to 44.

Note: Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.

*Data for 2019 are considered partial and may be incomplete and should be used with caution. One death had an age-range that was unknown. (Source: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 1/29/2020)

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Lucas County Number of Suicide Deaths By Age Group2010-2019*

Total Deaths =598

Common Signs of Mental Illness in Adults

• Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness can be difficult. There’s no easy test that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness. Knowing the warning signs can help determine if someone needs to speak to a professional. For many people, getting an accurate diagnosis is the first step in a treatment plan.

• Each illness has its own symptoms, but common signs of mental illness in adults can include: — Excessive worrying or fear — Feeling excessively sad or low — Extreme mood changes — Avoiding friends and social activities — Changing in sleep habits or feeling tired and having low energy — Changes in eating habits such as increased hunger or lack of appetite — Abuse of substances like alcohol or drugs — Inability to carry out daily activities or handle daily problems and stress

• After diagnosis, a health care provider can help develop a treatment plan that could include medication, therapy or other lifestyle changes.

• Getting a diagnosis is just the first step; knowing your own preferences and goals are also important. Treatments for mental illness vary by diagnosis and by person. There’s no “one size fits all” treatment. Treatment options can include medication, counseling (therapy), social support and education.

(Source: National Alliance on Mental Illness, Know the Warning Signs, 2018)

CARDIOVASCULAR HEALTH | 101

Chronic Disease: Cardiovascular Health

Key Findings

Four percent (4%) of adults had survived a heart attack and 3% had survived a stroke at some time in their life. Thirty-nine percent (39%) had high blood pressure, 38% were obese, 27% had high blood cholesterol, and 15% were current smokers, which are four known risk factors for heart disease and stroke.

Heart Disease and Stroke • Four percent (4%) of adults reported they were diagnosed

with angina. • Sixty percent (60%) of those with angina were receiving

treatment for the diagnosis. • Four percent (4%) of adults reported they had a heart

attack. • Sixty-eight percent (68%) of those who had a heart attack

reported currently receiving treatment for the diagnosis.

• Three percent (3%) of adults reported they had a stroke. • Forty-three percent (43%) of those who had a stroke


• Six percent (6%) of adults reported they had heart disease, increasing to 14% of those older than the age of 65. • More than four-fifths (84%) of adults with heart disease were receiving treatment for it.

High Blood Pressure (Hypertension)

• Nearly two-fifths (39%) of adults had been diagnosed with high blood pressure. Ninety-one percent (91%) of adults reported they were currently receiving treatment for the diagnosis.

• Lucas County adults diagnosed with high blood pressure were more likely to have:

— Been classified as overweight or obese by body mass index (BMI) (87%) — Been ages 65 years or older (65%) — Annual incomes less than $25,000 (60%)

High Blood Cholesterol

• More than one-fourth (27%) of adults had been diagnosed with high blood cholesterol. Eighty percent (80%) of adults reported they were currently receiving treatment for the diagnosis.

• More than three-quarters (81%) of adults had their blood cholesterol checked within the past five years. • Lucas County adults with high blood cholesterol were more likely to:

— Have been classified as overweight or obese by body mass index (BMI) (83%)

Lucas County Leading Causes of Death

2016-2018

Total Deaths: 14,042

1. Heart Disease (25% of all deaths) 2. Cancer (21%) 3. Accidents, Unintentional Injuries (7%) 4. Chronic Lower Respiratory Diseases (6%) 5. Stroke (5%)


Ohio Leading Causes of Death

2016-2018


1. Heart Disease (23% of all deaths) 2. Cancers (21%) 3. Accidents, Unintentional Injuries (7%) 4. Chronic Lower Respiratory Diseases (6%) 5. Stroke (5%)


4% of Lucas County adults or approximately 13,069 adults survived a heart attack or myocardial infarction.


39%44%

34%

7%

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65%60%

34% 34%

55%

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Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with High Blood Pressure*

— Have been ages 65 years or older (46%) — Annual incomes less than $25,000 (45%)

The following graphs show the number of Lucas County adults who have been diagnosed with high blood pressure and high blood cholesterol. Examples of how to interpret the information on the first graph include: 39% of all Lucas County adults have been diagnosed with high blood pressure, including 44% of males, 34% of females, and 65% of those 65 years and older.

*Does not include respondents who indicated high blood pressure during pregnancy only.


27% 27% 27%

3%

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23% 27%31%

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Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with High Blood Cholesterol


The following graph demonstrates the percentage of Lucas County adults who had major risk factors for developing cardiovascular disease (CVD).

Healthy People 2020 Objectives Heart Disease and Stroke (HDS)

Note: All U.S. figures age-adjusted to 2000 population standard. (Source: Healthy People 2020, 2017 BRFSS, 2019/2020 Lucas County Health Assessment)

Objective

2020 Lucas Survey

Population Baseline

2017 U.S. Baseline

Healthy People 2020 Target

HDS-5: Reduce proportion of adults with hypertension

39% 35%

Adults age 18 and older

27%

HDS-6: Increase proportion of adults who had their blood cholesterol checked within the preceding 5 years

81% 85%

Adults age 18 and older

82%

HDS-7: Decrease proportion of adults with high total blood cholesterol (TBC)

27%

33%

Adults age 20+ with

TBC>240 mg/dl

14%

39% 38%

25%

15%13%

0%

25%

50%


Lucas County Adults with Cardiovascular Disease Risk Factors


The following graph shows the percentage of Lucas County adults who had survived a heart attack or stroke in their lifetime by gender. An example of how to interpret the information includes: 5% of Lucas County males survived a heart attack compared to 3% of females.




County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Had angina 7% 3% 5% 2% 4% 5% 4% Had a heart attack N/A 3% 5% 5% 4% 5% 4% Had a stroke N/A 2% 3% 3% 3% 4% 3% Had been diagnosed with high blood pressure

35% 34% 37% 34% 39% 35% 32%


34% 27% 25% 25% 27% 33% 33%


72% 76% 80% 77% 81% 85% 87%

4%5%

3%3% 3% 3%

0%

2%

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6%

8%

10%

Total Male Female

Lucas County Adults Who Had Survived a Heart Attack or Stroke In Their Lifetime

Heart Attack Stroke


The following graphs show the age-adjusted mortality rates per 100,000 population for heart disease and stroke. • When age differences are accounted for, the statistics indicate that the Lucas County heart disease mortality

rate was higher than the figures for the state, the U.S., and the Healthy People 2020 target from 2016 to 2018. • The 2016 to 2018 Lucas County age-adjusted stroke mortality rate was higher than the figures for the state, the

U.S., and the Healthy People 2020 target. • From 2010 to 2018, Lucas County female and male age-adjusted heart disease mortality rates fluctuated.

*The Healthy People 2020 Target objective for coronary heart disease is reported for heart attack mortality. (Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2015-2017, Healthy People 2020)


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Age-Adjusted Heart Disease and Stroke Mortality Rates

Lucas County 2016-2018 Ohio 2016-2018 U.S. 2016-2018 HP 2020 Target*

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Lucas County Age-Adjusted Heart Disease Mortality Rates by Gender

Lucas County Total Lucas County Male Lucas County Female


The following graph shows the age-adjusted mortality rates per 100,000 population for stroke by gender. • From 2010 to 2018, the Lucas County stroke mortality rate stayed relatively stable.


The following graph shows the age-adjusted mortality rates per 100,000 population for heart disease and stroke by race. The graph shows: • From 2016 to 2018, the age-adjusted stroke and heart disease mortality rates were higher in the African

American population than in the white and Latino populations.

(Source for graphs: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 3/27/20)

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Age-Adjusted Stroke Mortality Rates by Gender

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Lucas County Age-Adjusted Heart Disease and Stroke Mortality Rates by Race, 2016-2018

Stroke Heart Disease

CANCER | 107

Cancer Fast Facts

• Cancer is the second leading cause of death in the United States, but many kinds of cancer can be prevented or caught early.

• Leading risk factors for preventable cancers are smoking, getting too much UV radiation from the sun or tanning beds, being overweight or obese, and drinking too much alcohol.

• Some kinds of cancer (like breast, cervical, and colorectal) can be caught early through screening. Other kinds of cancer can be prevented. For example, cervical cancer through vaccination and colorectal cancer can be prevented through removing precancerous growths in the colon and rectum.

• The cost of cancer care in the United States is expected to reach almost $174 billion by 2020.

(Source: CDC, National Center for Chronic Disease Prevention and Health Promotion, Cancer, Updated April 15, 2020)

Chronic Disease: Cancer

Key Findings In 2020, 12% of Lucas County adults were been diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (2,980) of all (14,042) Lucas County resident deaths.

Adult Cancer • Twelve percent (12%) of Lucas County adults were

diagnosed with cancer at some point in their lifetime, increasing to 29% of those over the age of 65.

• Of those diagnosed with cancer, they reported the

following types: breast (29%), other skin cancer (20%), prostate (9%), melanoma (7%), cervical (6%), bladder (5%), leukemia (3%), endometrial (3%), colon (3%), renal (3%), lung (3%), head and neck (1%), esophageal (1%), bone (1%), non-Hodgkin’s lymphoma (1%), and other types of cancer (13%). Nine percent (9%) of adults were diagnosed with multiple types of cancer.

• Lucas County adults reported receiving the following cancer screenings:

— Colorectal cancer in the past five years (26%) — Oral cancer in the past year (16%) — Skin cancer in the past year (15%) — Lung cancer in the past three years (4%)

Cancer Facts • The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (2,980) of all

(14,042) Lucas County resident deaths (Source: Ohio Public Health Data Warehouse, 2016-2018).

• The American Cancer Society states that about 606,520 Americans are expected to die of cancer in 2019. Cancer is the second leading cause of death in the U.S., exceeded only by heart disease (Source: American Cancer Society, Facts & Figures 2020).

Lucas County Incidence of Cancer, 2013-2017

All Types: 11,959 cases

• Lung and Bronchus: 1,729 cases (14%) • Breast: 1,679 cases (14%) • Prostate: 1,468 cases (12%) • Colon and Rectum: 1,097 cases (9%) In 2016-2018, there were 2,980 cancer deaths in

Lucas County. (Source: Ohio Cancer Incidence Surveillance System, Ohio Public

Health Data Warehouse, 2013-2017)

12% of Lucas County adults, or approximately 39,206 adults were diagnosed with cancer at some point in their lifetime.

CANCER | 108

The following graph shows the Lucas County, Ohio and U.S. age-adjusted mortality rates (per 100,000 population) for all types of cancer in comparison to the Healthy People 2020 objective.

(Source: Ohio Public Health Data Warehouse, CDC Wonder, Healthy People 2020) The following graph shows cancer as a percent of total deaths in Lucas County.


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Healthy People 2020 Objectiveand Age-Adjusted Mortality Rates for All Cancers

Lucas County 2016-2018 Ohio 2016-2018 U.S. 2016-2018 HP 2020 Target

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Cancer as a Percent of All Total Deaths in Lucas Countyby Gender, 2016-2018

CANCER | 109

Breast Cancer • In 2020, 55% of Lucas County females reported having a clinical breast examination in the past year.

• More than half (58%) of Lucas County females older than the age of 40 had a mammogram in the past year. • For women at average risk of breast cancer, recently updated American Cancer Society screening guidelines

recommend that those 40 to 44 years of age have the option to begin annual mammography, those 45 to 54 should undergo annual mammography, and those 55 years of age and older may transition to biennial mammography or continue annual mammography. Women should continue mammography as long as overall health is good and life expectancy is 10 or more years. For some women at high risk of breast cancer, annual magnetic resonance imaging (MRI) is recommended in addition to mammography, typically starting at age 30 (Source: American Cancer Society, Facts & Figures 2020).

The following graph shows the Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for breast cancer in comparison with the Healthy People 2020 objective.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018) Prostate Cancer

• Nearly half (48%) of Lucas County men had a digital rectal exam in their lifetime, and 12% had one in the past

year.

• ODH statistics indicate that prostate cancer accounted for 9% of all male cancer deaths from 2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018).

• No organizations presently endorse routine prostate cancer screening for men at average risk because of

concerns about the high rate of overdiagnosis (detecting disease that would never have caused symptoms or harm), along with the significant potential for serious side effects associated with prostate cancer treatment. The American Cancer Society recommends that beginning at age 50, men who are at average risk of prostate cancer and have a life expectancy of at least 10 years have a conversation with their health care provider about the benefits and limitations of PSA testing and make an informed decision about whether to be tested based on their personal values and preferences. Men at high risk of developing prostate cancer (Black men or those with a close relative diagnosed with prostate cancer before the age of 65) should have this discussion beginning at age 45, and men at even higher risk (those with several close relatives diagnosed at an early age) should have this discussion beginning at age 40 (Source: American Cancer Society, Facts & Figures 2020).

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CANCER | 110

The following graph shows the Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for prostate cancer in comparison with the Healthy People 2020 objective.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018)

Lung Cancer • In Lucas County, 15% of male adults were current smokers and 25% were former smokers.

• ODH reports that lung and bronchus cancer (total deaths=802) was the leading cause of male cancer deaths

from 2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018). • ODH reports that lung and bronchus cancer was the leading cause of female cancer deaths (total deaths=387)

in Lucas County from 2016 to 2018, followed by breast (total deaths=184) and colorectal cancers (total deaths=142) (Source: Ohio Public Health Data Warehouse, 2016-2018).

• According to the American Cancer Society, smoking causes 80% of lung cancer deaths in the U.S. Men and

women who smoke are about 25 times more likely to develop lung cancer than nonsmokers (Source: American Cancer Society, Facts & Figures 2020).

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Lucas County Age-Adjusted Mortality Rates for Prostate Cancer


CANCER | 111

The following graphs show the Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for lung and bronchus cancer in comparison with the Healthy People 2020 objective, as well as by gender.

*Healthy People 2020 Target data is for lung cancer only (Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018)

(Source: Ohio Public Health Data Warehouse 2016-2018)

Colorectal Cancer

• ODH indicates that colorectal cancer accounted for 9% of all male and 10% of female cancer deaths from 2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018).

• Modifiable factors that increase colorectal cancer risk include obesity, physical inactivity, long-term smoking, high consumption of red or processed meat, low calcium intake, moderate to heavy alcohol consumption, and very low intake of fruits and vegetables and whole-grain fiber. Hereditary and medical factors that increase risk include a personal or family history of colorectal cancer and/or polyps, certain inherited genetic conditions, a personal history of chronic inflammatory bowel disease, and type 2 diabetes (Source: American Cancer Society, Facts & Figures 2020).

• Screening can prevent colorectal cancer through the detection and removal or precancerous growths, as well as detect cancer at an early stage. Regular screenings with either stool tests or exams (e.g., colonoscopy) results in a reduction in premature colorectal cancer death. New guidelines from the American Cancer Society recommend men and women at average risk for colorectal cancer be screened starting at age 45 (Source: American Cancer Society, Facts & Figures 2020).

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CANCER | 112

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Lucas County Colorectal Cancer Age-Adjusted Mortality Rates by Gender, 2016-2018

The following graphs show Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for colorectal cancer in comparison with the Healthy People 2020 objective, as well as by gender.

(Source: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018`)


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Lucas County Age-Adjusted Mortality Rates for Colorectal Cancer


CANCER | 113

2020 Cancer Estimates

• In 2020, more than 1.8 million new cancer cases are expected to be diagnosed. • The World Cancer Research Fund estimates that about 18% of the new cancer cases expected to occur in the

U.S. in 2020 will be related to being overweight or obsity, physical inactivity, and poor nutrition, and thus could be prevented.

• About 606,520 Americans are expected to die of cancer in 2020. • 80% of lung cancer deaths in the U.S are attributed to smoking. • In 2019, estimates predicted that there will be 71,850 new cases of cancer and 25,380 cancer deaths in Ohio. • Of the new cancer cases in Ohio, approximately 10,110 (14%) will be from lung and bronchus cancers and

4,100 (6%) will be from melanoma (skin) cancer. • About 10,350 new cases of female breast cancer are expected in Ohio. • New cases of male prostate cancer in Ohio are expected to be 7,030 (10%).

(Source: American Cancer Society, Facts and Figures 2020)

Lucas County Incidence of Cancer, 2013-2017

Types of Cancer Age-Adjusted Rate Number of Cases

Lung and Bronchus 66.6 1,729 Breast 67.0 1,679 Prostate 67.0 1,679 Colorectal 114.8 1,468 Other Sites/Types 33.9 857 Bladder 22.7 583 Melanoma of Skin 21.4 535 Non-Hodgkins Lymphoma 18.3 461 Uterus 29.6 433 Kidney & Renal Pelvis 16.4 419 Pancreas 14.9 388 Oral Cavity & Pharynx 12.4 335 Thyroid 13.8 303 Leukemia 11.2 278 Liver & Intrahepatic Bile Duct 7.4 205 Stomach 7.4 185 Brain and Other CNS 7.4 176 Multiple Myeloma 6.9 175 Ovary 12.2 165 Esophagus 6.1 161 Larynx 4.2 110 Cervix 8.4 96 Hodgkins Lymphoma 3.3 73 Testis 4.8 48

Total 11,959 (Source: Ohio Cancer Incidence Surveillance System, ODH Information Warehouse, Updated 2/7/2020)

ARTHRITIS | 114

Chronic Disease: Arthritis

Key Findings Eighteen percent (18%) of Lucas County adults were diagnosed with arthritis.

Arthritis • Eighteen percent (18%) of Lucas County adults were diagnosed with arthritis, increasing to 38% of those older

than the age of 65.

• Sixty-six percent (66%) of adults with arthritis were currently receiving treatment for their diagnosis.

The following graph shows the percentage of Lucas County adults who were told by a doctor they had arthritis. An example of how to interpret the information includes: 18% of adults were told they had arthritis, including 17% of males and 38% of adults ages 65 and older.


Adult Comparisons

Lucas County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Diagnosed with arthritis 27% 19% 19% 23% 18% 31% 26%

18% of Lucas County adults, or approximately 58,809 adults were diagnosed with arthritis.

18% 17% 19%

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Lucas2020

Males Females 30 Years&

Younger

30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed With Arthritis

ARTHRITIS | 115

The following graphs demonstrate the lifetime prevalence rates of arthritis by gender for Ohio residents.

(Source: 2018 BRFSS)

Arthritis: Key Public Health Messages

Early diagnosis of arthritis and self-management activities can help people decrease their pain, improve function, and stay productive.

Key self-management activities include the following:

1. Learn arthritis management strategies – Arthritis management strategies provide those with arthritis with the skills and confidence to effectively manage their condition. Self-Management Education has proven to be valuable for helping people change their behavior and better manage their arthritis symptoms. Interactive workshops such as the Arthritis Self-Management Program and the Chronic Disease Self-Management Program are low-cost (about $25 – $35) and available in communities across the country. Attending one of these programs can help a person learn ways to manage pain, exercise safely, and gain control of arthritis.

2. Be active – Research has shown that physical activity decreases pain, improves function, and delays disability. Make sure you get at least thirty minutes of moderate physical activity at least five days a week. You can get activity in ten-minute intervals.

3. Watch your weight – The prevalence of arthritis increases with increasing weight. Research suggests that maintaining a healthy weight reduces the risk of developing arthritis and may decrease disease progression. A loss of just eleven pounds can decrease the occurrence (incidence) of new knee osteoarthritis and a modest weight loss can help reduce pain and disability.

4. See your doctor – Although there is no cure for most types of arthritis, early diagnosis and appropriate management is important, especially for inflammatory types of arthritis. For example, early use of disease-modifying drugs can affect the course of rheumatoid arthritis. If you have symptoms of arthritis, see your doctor and begin appropriate management of your condition.

5. Protect your joints – Joint injury can lead to osteoarthritis. People who experience sports or occupational injuries or have jobs with repetitive motions like repeated knee bending have more osteoarthritis. Avoid joint injury to reduce your risk of developing osteoarthritis.

(Source: Centers for Disease Control and Prevention, Arthritis: Key Public Health Messages, Updated on February 5, 2019)

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Ohio Adult Lifetime Arthritis Prevalence Rates By Gender

ASTHMA | 116

Chronic Disease: Asthma Key Findings In 2020, 13% of Lucas County adults were diagnosed with asthma. Asthma and Other Respiratory Disease • In 2020, 13% of Lucas County adults were diagnosed with asthma.

• Sixty-eight percent (68%) of adults with asthma were currently receiving treatment for their diagnosis. • Four percent (4%) of adults were diagnosed with chronic obstructive pulmonary disorder (COPD).

• Seventy-nine percent (79%) of adults were diagnosed with chronic obstructive pulmonary disorder (COPD) and

were currently receiving treatment.

• There are several important factors that may trigger an asthma attack. Some of these triggers are tobacco smoke; dust mites; outdoor air pollution; cockroach allergens; pets; mold; smoke from burning wood or grass; and infections linked to the flu, colds, and respiratory viruses (Source: CDC, Asthma, Updated September 6, 2019).

• Chronic lower respiratory disease was the fourth leading cause of death in Lucas County and the fourth leading

cause of death in Ohio in 2016 to 2018 (Source: Ohio Public Health Data Warehouse, 2016-2018).

The following graph shows the percentage of Lucas County adults who were diagnosed with asthma. Examples of how to interpret the information include: 13% of adults were diagnosed with asthma, including 15% of females and 37% of those younger than the age of 30.


Adult Comparisons

Lucas County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Diagnosed with asthma 12% 13% 13% 10% 13% 11% 10%

13%10%

15%

37%39%

10%13% 12% 11%

19%

13% 13% 13%10%

0%

10%

20%

30%

40%

50%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with Asthma

ASTHMA | 117

The following graph shows the percentage of Lucas County adults who were diagnosed with COPD. Examples of how to interpret the information include: 4% of adults were diagnosed with COPD, including 10% of adults with annual incomes less than $25,000 and 13% of adults ages 65 and older.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey. The following graph shows the Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for chronic lower respiratory diseases (formerly COPD) in comparison with the Healthy People 2020 objective. The graph shows: • From 2016 to 2018, Lucas County’s age-adjusted mortality rate for chronic lower respiratory disease was higher

than the Ohio and U.S. rate but lower than the Healthy People 2020 target objective rate.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018) *Healthy People 2020’s target rate is for adults aged 45 years and older.

4%5%

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1%

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20%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with COPD

5748

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Age-Adjusted Mortality Rates for Chronic Lower Respiratory Diseases (Formerly COPD)


ASTHMA | 118

Asthma Facts

• The number of Americans with asthma grows every year. Currently, 26.5 million Americans have asthma. • More than 3,500 people die of asthma each year, nearly half of whom are age 65 or older. • Asthma results in 439,000 hospitalizations and 1.3 million emergency room visits annually. • Annually, patients with asthma reported 11 million visits to a doctor’s office and 1.7 million visits to hospital

outpatient departments • Effective asthma treatment includes monitoring the disease with a peak flow meter, identifying and avoiding

allergen triggers, using drug therapies including bronchodilators and anti-inflammatory agents, and developing an emergency plan for severe attacks.

(Source: American College of Allergy, Asthma, & Immunology, Asthma Facts, updated June 13, 2018)

The following graphs demonstrate the lifetime and current prevalence rates of asthma by gender for Ohio residents.

(Source: 2018 BRFSS)

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Ohio Adult Current Asthma Prevalence Rates By Gender

12%

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Ohio Adult Lifetime Asthma Prevalence Rates By Gender

DIABETES | 119

Chronic Disease: Diabetes

Key Findings In 2020, 13% of Lucas County residents reported they were diagnosed with diabetes at some time in their lifetime. More than one-third (37%) of adults with diabetes rated their health as fair or poor.

Diabetes • Thirteen percent (13%) of Lucas County adults were diagnosed with diabetes at some time in their lifetime,

increasing to 26% of those older than the age of 65. • One hundred percent (100%) of adults with diabetes were currently receiving treatment for the diagnosis.

• A test for A1C measures the average level of blood sugar over the past three months. Seven percent (7%) of

Lucas County adults reported getting their A1C checked three or more times in the past year. Nine percent (9%) said two times, 25% said one time, 42% said none and 18% said they did not know if they had gotten their A1C checked within the past year.

• More than one-third (37%) of adults with diabetes rated their health as fair or poor. • Lucas County adults diagnosed with diabetes also had one or more of the following characteristics or

conditions: — Overweight or obese (90%) — High blood cholesterol (27%) — High blood pressure (25%)

The following graph shows the percentage of Lucas County adults who were diagnosed with diabetes. Examples of how to interpret the information include: 13% of adults were diagnosed with diabetes, including 14% of males and 26% of adults ages 65 and older.


13% of adults, or approximately 42,473 adults were diagnosed with diabetes.

13% 14%12%

0%

14%

26% 26%

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12%

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30%

40%

Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults Diagnosed with Diabetes

DIABETES | 120

Statistics About Diabetes

• Among the US population overall, crude estimates for 2018 indicated that: 34.2 million people of all ages—or 10.5% of the US population—had diabetes.

34.1 million adults aged 18 years or older—or 13.0% of all US adults—had diabetes. 7.3 million adults aged 18 years or older who met laboratory criteria for diabetes were not aware of

or did not report having diabetes. This number represents 2.8% of all US adults and 21.4% of all US adults with diabetes.

The percentage of adults with diabetes increased with age, reaching 26.8% among those aged 65 years or older.

• Among adults aged 18 or older in the U.S., 1.5 million new cases, or 6.9 per 1,000 persons, were diagnosed in 2018.

• Compared to adults aged 18 to 44 years, incidence rates of diagnosed diabetes in 2018 were higher among adults aged 45 to 64 years and those aged 65 years and older

• Prevalence of diagnosed diabetes was highest among American Indians/Alaska Native people (14.7%), people of Hispanic origin (12.5%), and non-Hispanic Black people (11.7%), followed by non-Hispanic Asians people (9.2%) and non-Hispanic white people (7.5%)

(Source: CDC, 2020 National Diabetes Statistics Report, Updated February 14, 2020)

The following graphs show prevalence of diabetes by gender and the age-adjusted mortality rates from diabetes for Lucas County and Ohio residents with comparison to the Healthy People 2020 target objective. • From 2016 to 2018, Lucas County’s age-adjusted diabetes mortality rate was higher than Ohio and the U.S.,

but lower than the Healthy People 2020 target objective rate.

*The Healthy People 2020 rate is for all diabetes-related deaths.

(Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2015-2017, Healthy People 2020)


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Diagnosed with diabetes 12% 13% 15% 12% 13% 12% 11%

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Lucas County Age-Adjusted Mortality Rates for Diabetes


QUALITY OF LIFE | 121

Chronic Disease: Quality of Life

Key Findings In 2020, 37% of Lucas County adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were back or neck problems (44%); arthritis/rheumatism (38%); stress, depression, anxiety and emotional problems (32%); chronic pain (25%); and sleep problems (22%).

Impairments and Health Problems • More than one-third (37%) of Lucas County adults were limited in some way because of a physical, mental or

emotional problem increasing to 60% of those with annual incomes less than $25,000.

• Those who were limited in some way reported the following most limiting problems or impairments:

— Back or neck problems (44%) — Arthritis/rheumatism (38%) — Stress, depression, anxiety, or emotional

problems (32%) — Chronic pain (25%) — Sleep problems (22%) — Walking problems (19%) — Chronic illness (19%) — Fitness level (16%) — Fractures, bone/joint injuries (15%) — Eye/vision problems (14%)

— Lung/breathing problems (11%) — Memory loss (8%) — Dental problems (8%) — Hearing problems (6%) — Mental health illness/disorder (4%) — Confusion (4%) — Learning disability (2%) — Substance dependency (2%) — Drug addiction (2%) — Other impairments/problems (7%)

• In 2020, Lucas County adults reported needing the following services or equipment: eyeglasses or vision services (32%), pain management (8%), canes (7%), walkers (5%), medical supplies (5%), help with routine needs (5%), help with personal care needs (4%), hearing aids or hearing care (3%), wheelchairs (2%), oxygen or respiratory support (1%), wheelchair ramps (1%), a personal emergency response systems (1%), mobility aids or devices (1%), and special beds (1%).

• More than one-fourth (27%) of Lucas County adults had fallen in the past year, increasing to 37% of those 65 and older.

N/A – Not Available *2015 BRFSS Data


County 2007

Lucas County 2011

Lucas County 2014

Lucas County 2017

Lucas County 2020

Ohio 2019

U.S. 2019

Limited in some way because of physical, mental or emotional problem

42% N/A 47% 43% 37% 21%* 20%*

37% of Lucas County adults, or approximately 120,885 adults were limited in some way because of a physical, mental or emotional problem.


The following graphs show the percentage of Lucas County adults who were limited in some way and the most limiting health problems. Examples of how to interpret the information on the first graph include: 37% of Lucas County adults were limited in some way, including 32% of males and 44% of those ages 65 and older.


Healthy People 2020 Arthritis, Osteoporosis, and Chronic Back Conditions (AOCBC)


2020 Healthy People

2020 Target

AOCBC-2: Reduce the proportion of adults with doctor-diagnosed arthritis who experience a limitation in activity due to arthritis or joint symptoms

38% 36%

Note: U.S. baseline is age-adjusted to the 2000 population standard. (Sources: Healthy People 2020 Objectives, 2019/2020 Lucas County Health Assessment)

44%

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32%

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Back/Neck Problems Arthritis/Rheumatism Stress, Depression,Anxiety, or Emotional

Problems

Chronic Pain Sleep Problems

Lucas County Adults' Most Limiting Health Problems

37%32%

42%

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Lucas2020


30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2014

Lucas2017

Lucas County Adults Limited in Some Way

SOCIAL DETERMINANTS OF HEALTH | 123

Social Conditions: Social Determinants of Health

Key Findings

In 2020, 8% of Lucas County adults had to choose between paying bills and buying food. Fifteen percent (15%) of adults experienced four or more adverse childhood experiences (ACEs) in their lifetime.

Healthy People 2020

• Healthy People 2020 developed five key determinants as a “place-based” organizing framework. These five determinants include:

— Economic stability — Education — Social and community context — Health and health care — Neighborhood and built environment

Economic Stability • Adults reported the following about their housing

situation: — Had housing (93%) — Had housing, but were worried about losing housing in the future (5%) — Did not have housing (1%) — Don’t know (1%)

• Lucas County adults attempted to get assistance from the following social service agencies: Job & Family Services/JFS (11%), friend or family member (4%), food pantries (4%), Pathway (2%), place of worship (2%), WIC/health department (2%), Salvation Army (2%), free clinic (1%), United Way (1%), other charities (1%), legal aid (1%), and somewhere else (3%). Three percent (3%) did not know where to look for assistance, and 5% did not qualify for assistance.

• Adults experienced the following food insecurity issues during the past year: had to choose between paying bills and buying food (8%), worried food would run out (5%), food assistance was cut (4%), loss of income led to food insecurity issues (4%), went hungry/ate less to provide more food for their family (3%), and were hungry but did not eat because they did not have money for food (3%).

• Seven percent (7%) of adults experienced more than one food insecurity issue.

• According to the 2019 American Community Survey 1-year Estimates, the median household income in Lucas County was $49,448. The U.S. Census Bureau reports median annual income levels of $58,642 for Ohio and $65,712 for the U.S. (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

• According to the 2019 American Community Survey 1-year Estimates, 18% of all Lucas County residents were living in poverty, and 27% of children and youth ages 0-17 were living in poverty (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

• The unemployment rate for Lucas County was 10.6 as of July 2020 (Source: Bureau of Labor Statistics, Local Area Unemployment Statistics).

• According to the 2019 American Community Survey 1-year Estimates, in Lucas County, there were 203,795

housing units. The owner-occupied housing unit rate was 60%. Rent in Lucas County cost an average of $757 per month (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

7% of Lucas County adults, or approximately 22,870 adults experienced more than one food insecurity issue in the past year.

http://ohiolmi.com/laus/laus.htm



Lucas County adults and their loved ones needed the following assistance in the past year:

Type of Assistance Received

Assistance

Did Not Know

Where to Look

Did Not Need

Assistance

Acquiring disability benefits 9% 2% 89%

Affordable child care <1% 4% 96%

Clothing 1% 3% 97%

Credit counseling 3% 4% 92%

Dental care 8% 3% 89%

Diapers 1% 1% 98%

Drug or alcohol addiction 2% 2% 97%

Employment 3% 2% 94%

Food 8% 2% 90%

Free tax preparation 3% 5% 93%

Gambling addiction <1% 1% 99%

Electric, gas, or water bills 5% 3% 93%

Health care 11% 3% 86%

Home repair 3% 4% 93%

Legal aid services 1% 3% 96%

Medicare 11% 2% 87%

Mental illness issues including depression 9% 3% 88%

Post incarceration transition issues 1% 1% 98%

Prescription assistance 9% 2% 88%

Rent/mortgage 2% 4% 94%

Septic/well repairs <1% 1% 99%


Unplanned pregnancy <1% 1% 99%

Utilities 3% 3% 94%


The map below shows the variation in poverty rates across Ohio during the 2013 to 2017 period. • The 2013 to 2017 American Community Survey 5-year estimates report that approximately 1,683,890 Ohio

residents, or 14.9% of the population, were living in poverty.

• From 2013 to 2017, 19.8% of Lucas County residents were living in poverty

Estimated Poverty Rates in Ohio by County (2013-2017)

(Source: 2013-2017 American Community Survey five-year estimates, as compiled by Ohio Development Services Agency, Office of Research, Ohio Poverty Report, February 2019)


Social and Community Context • Lucas County adults experienced the following in the past year:

— Death of a family member or close friend (40%) — A close family member had to go to the hospital (35%) — Had bills they could not pay (15%) — Someone close to them had a problem with drinking or drugs (10%) — Someone in their household lost their job/had their hours at work reduced (10%) — Decline in their own health (10%) — Moved to a new address (8%) — Were a caregiver (6%) — Due to unforeseen circumstances, their household income was cut by 50% (4%) — Knew someone who lived in a hotel (4%) — Was threatened or abused by someone physically, emotionally, sexually, and/or verbally (4%) — Had someone homeless living with them or sleeping on their couch (3%) — Became separated or divorced (2%) — Was homeless (1%) — Had a child who was threated or abused by someone physically, emotionally, sexually, and/or verbally (1%) — Their family was at risk for losing their home (1%) — Witnessed someone in their family being hit or slapped (1%)

• Forty-five percent (45%) of Lucas County adults reported gambling in the past year. They reported the

following types of gambling: lottery/scratch-offs/office pools (32%); casino gambling (17%); sports betting with a bookie/office pools (5%); poker or other card games, dice, or craps (not at a casino) (4%); bingo (3%), fantasy sports/online betting (3%); and horse/dog racing track (<1%).

• Lucas County adults reported engaging in some form of gambling:

— Daily (1%) — Every few days (2%) — Weekly (5%) — Every few weeks (4%) — Monthly (3%) — Every few months (14%) — Once or twice a year (29%) — Never (43%)

• Adults experienced the following due to gambling: consumed more alcohol or drugs when gambling (1%), felt the need to lie to hide the extent of their gambling (1%), unable to pay bills (1%), gambled with larger amounts of money to get the same excitement (<1%), someone expressed a concern about their gambling (<1%), tried to cut down or stop gambling (<1%), borrowed money or relied on someone to pay their bills (<1%), lied to family members or others to hide their gambling (<1%), restless or irritable when trying to cut down or stop gambling (<1%), and jeopardized a significant relationship due to gambling (<1%).

• Fourteen percent (14%) of Lucas County adults were threatened with abuse in the past year. Those who were

threatened with abuse were threatened in the past year by the following people: a spouse or partner (32%) and someone else (68%).

• Ten percent (10%) of Lucas County adults were abused (including physical, sexual, emotional, financial and verbal) in the past year. Those who were abused were abused in the past year by the following individuals: a spouse or partner (85%), a parent (8%), another person from outside the home (8%), and someone else (38%).


• Adverse childhood experiences (ACEs) are stressful or traumatic events, including abuse and neglect. They also include household dysfunction such as witnessing domestic violence or growing up with family members who have substance use disorders. ACEs are strongly related to the development of depression, alcoholism and alcohol abuse; depression; illicit drug use; chronic obstructive pulmonary disease; suicide attempts; and many other health problems throughout a person’s lifespan (SAMHA, Adverse Childhood Experiences, Updated on July 2, 2020).

• Lucas County adults experienced the following adverse childhood experiences (ACEs): — Their parents became separated or were divorced (27%) — Lived with someone who was a problem drinker or alcoholic (23%) — A parent or adult in their home swore at them, insulted them, or put them down (19%) — Lived with someone who was depressed, mentally ill, or suicidal (18%) — Someone at least five years older than them or an adult touched them sexually (13%) — Lived with someone who used illegal stress drugs, or who abused prescription medications (10%) — Their parents or adults in their home slapped, hit, kicked, punched, or beat each other up (10%) — A parent or adult in their home hit, beat, kicked, or physically hurt them (9%) — Someone at least five years older than them or an adult tried to make them touch them sexually (8%) — Their family did not look out for each other, feel close to each other, or support each other (7%) — Their parents were not married (6%) — Lived with someone who served time or was sentenced to serve time in prison, jail or correctional facility (5%) — Someone at least five years older than them or an adult forced them to have sex (3%) — They didn’t have enough to eat, had to wear dirty clothing, and had no one to protect them (2%)

• Fifteen percent (15%) of Lucas County adults experienced four or more adverse childhood experiences (ACEs). The following graph shows the percentage of Lucas County adults who experienced four or more adverse child experiences (ACEs) in their lifetime. Examples of how to interpret the information on the graph include: 15% of all Lucas County adults had experienced four or more ACEs in their lifetime, including 18% of females and 30% of those ages 30 and younger.


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Lucas 2020 Male Female 30 Yearsand Under

30-64Years


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Latino

Lucas County Adults Who Experienced Four or More ACEs


The table below indicates correlations between those who experienced four or more ACEs in their lifetime and participating in risky behaviors, as well as other experiences. An example of how to interpret the information include: 36% of those who experienced four or more ACEs seriously considered attempting suicide in the past year, compared to 5% of those who did not experience any ACEs.

Behaviors of Lucas County Adults Experienced four or more ACEs vs. Did Not Experience Any ACEs*

Adult Behaviors Experienced four or more

ACEs

Did Not Experience Any ACEs

Current drinker (had at least one alcoholic beverage in the past month) 48% 44%

Seriously contemplated suicide (in the past year) 36% 5%

Current smoker (currently smoke on some or all days) 30% 24%

Binge drinker (drank five or more drinks for males and four or more for females on an occasion in the past month)

29% 59%

Misused prescription drugs (used prescription drugs either not prescribed to them or used them to get high or feel more alert in the past six months)

22% 4%

Had two or more sexual partners (in the past year) 18% 1% *ACEs indicate adults who self-reported having experienced four or more adverse childhood experiences in their lifetime. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

Adverse Childhood Experiences (ACEs)

• Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years), such as the following:

— experiencing violence, abuse, or neglect — witnessing violence in the home or community — having a family member attempt or die by suicide

• Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with the following issues:

— substance misuse — mental health problems — instability due to parental separation or household members being in jail or prison

• ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. However, ACEs can be prevented.

• ACEs are common. About 61% of adults surveyed across 25 states reported that they had experienced at least one type of ACE, and nearly 1 in 6 reported they had experienced four or more types of ACEs.

• Preventing ACEs could potentially reduce a large number of health conditions. For example, up to 1.9 million cases of heart disease and 21 million cases of depression could have been potentially avoided by preventing ACEs.

• Some children are at greater risk than others. Women and several racial/ethnic minority groups were at greater risk for having experienced 4 or more types of ACEs.

• ACEs are costly. The economic and social costs to families, communities, and society totals hundreds of billions of dollars each year.

• ACEs can have lasting, negative effects on health, well-being, and opportunity. These experiences can increase the risks of injury, sexually transmitted infections, maternal and child health problems, teen pregnancy, involvement in sex trafficking, and a wide range of chronic diseases and leading causes of death such as cancer, diabetes, heart disease, and suicide.

(Source: CDC Violence Prevention, Fast Facts, Updated April 3. 2020)


Veterans Affairs

• As a result of military service during the past 10-15 years, the following have affected Lucas County veterans’ immediate family members: post-traumatic stress disorder (PTSD) (11%), access to medical care at a Veterans Affairs facility (7%), marital problems (5%), had problems getting Veterans Affairs benefits (4%), had problems getting information on Veterans Affairs eligibility and applying (4%), major health problems due to injury (3%), suicide attempt (2%), suicide completion (2%), access to mental health treatment (2%), housing issues (2%), substance/drug abuse/overdose (2%), could not find/keep a job (1%), access to medical care at a non-Veterans Affairs facility (1%), incarceration/re-entry (1%), and access to substance/drug use treatment (<1%).

Reactions to Race

• At work within the past year, 8% of Lucas County employed adults felt they were treated worse than people of other races. Fifty-eight percent (58%) felt they were treated the same at work, and 7% reported they were treated better than people of other races at work. Four percent (4%) of adults reported they were treated worse than people of some races but better than others. Four percent (4%) of adults reported they only encountered people of the same race at work.

• When seeking health care in the past year, 3% of Lucas County adults felt their experiences were worse than

people of other races. Fifty-one percent (51%) felt their experiences were the same, and 7% reported their experiences were better than people of other races when seeking health care.

• Seventeen percent (17%) of Lucas County adults reported feeling emotional distress (such as anger, sadness, or frustration) or physical distress (such as a stomachache, headache, anxiety) as a result of how they were treated based on their race, ethnicity, sex, age, language, culture, religion, nationality, or sexual orientation in the past month.

• During the past month, 12% of Lucas County adults experienced physical symptoms (for example, a headache,

an upset stomach, tensing of muscles, or a pounding heart) as a result of how they were treated based on their race.

• During the past month, adults felt emotionally upset as a result of how they were treated based on their:

— Skin color (9%) — Ethnicity (8%) — Religion (5%) — Sexual orientation (3%) — Culture (3%) — Gender identity (2%) — Disability (2%)

Lucas County Adults Experiences When Seeking Health Care*

Demographics

Experiences When Seeking Health Care Worse than People of

Other Races

Better than People of

Other Races

Same as People of

Other Races

Don’t Know

Total 3% 7% 51% 37%

African American 9% 0% 47% 33% White 1% 10% 53% 34%

Latino of any race 2% 7% 57% 22% *Percentages may not equal 100% due to the exclusion of data for those who did not have health care and answered multiple responses.


Neighborhood and Built Environment

• Just over one-fifth (21%) of Lucas County adults reported that their neighborhood was extremely safe, 50% reported it to be quite safe, 22% reported it to be slightly safe, and 4% reported it to be not safe at all. Four percent (4%) reported that they did not know how safe from crime their neighborhood was.

The following graph shows the percentage of Lucas County adults who described their neighborhood as extremely safe, quite safe and slightly/not safe. Examples of how to interpret the information include: 21% of all Lucas County adults described their neighborhood as extremely safe, including 24% of males and 12% of those with annual incomes less than $25,000.

*Respondents were asked: “How safe from crime do you consider your neighborhood to be?” Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey.

• Seventy percent (70%) of Lucas County adults reported deliberately testing all of the smoke detectors in their home within the past year. Nine percent (9%) have never tested the smoke detectors in their home. Four percent (4%) of adults reported no smoke detectors in their home.

• Twenty-eight percent (28%) of Lucas County adults reported the following transportation issues: no car (20%),

no driver’s license/suspended license (11%), limited public transportation available or accessible (5%), no car insurance (5%), cost of public or private transportation (5%), did not feel safe to drive (4%), other car issues/expenses (4%), disabled (2%), no public transportation available or accessible (1%), and could not afford gas (1%). Eighteen percent (18%) of adults who reported having transportation issues had more than one issue.

• Lucas County adults indicated they use the following forms of transportation regularly: vehicle or family vehicle (85%), ride from a friend or family member (22%), walk (11%), public transportation (9%), bike (3%), and other (9%).

• Lucas County adults reported doing the following while driving: talking on hand-held cell phone (52%); eating (35%); texting (29%); using cell phone other than for talking or texting (20%), using Internet/apps/social media on their cell phone (16%); driving without wearing a seatbelt (14%); being under the influence of alcohol (5%); reading (4%); being under the influence of prescription drugs (3%); being under the influence of recreational drugs (3%); and other activities (such as applying makeup, shaving, etc.) (3%). Forty-two percent (42%) of adults had more than one distraction. Eight percent (8%) of adults reported they did not drive.

• More than one-fourth (27%) of Lucas County adults kept a firearm in or around their home. Four percent (4%) of adults reported that their firearms were unlocked and loaded.

21% 24% 18% 17% 20% 20%12%

25% 24%13%

27%

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50% 42% 56%48%

51% 54%

45%

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39%

22% 24%

30%28%

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100%

Lucas2020

Males Females Under 30 30-64years

65 &Over

Income<$25K

Income$25KPlus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adult Neighborhood Safety Perceptions*

Extremely Safe Quite Safe Slightly/Not Safe


• Adults with firearms in or around their home reported the following reasons for having them: protection

(84%), hunting or sport (3%), and other reasons (6%). The following graph shows the percentage of Lucas County adults that have a firearm in or around the home. Examples of how to interpret the information include: 27% of all Lucas County adults had a firearm in or around the home, including 35% of males and 29% of those with annual incomes of $25,000 or more.


27%

35%

20%23%

29%26%

22%

29% 29%

22%

26% 25%

31%

35%

0%

10%

20%

30%

40%

Lucas2020

Male Female 30 andYounger

30-64Years

65 &Over

Income<$25K

Income$25K Plus


Latino Lucas2011

Lucas2014

Lucas2017

Lucas County Adults With a Firearm in or Around the Home

Victims of Gun Violence in America

• Every year, 114,328 people are shot in murders, assaults, suicides & suicide attempts, accidents or by police intervention in America in an average year. — 37,603 people die from gun violence and 76,725 people survive gun injuries.

• Every day, an average of 313 persons are shot in America. Of those 313 people, 103 people die and 210 are shot, but survive. — Of the 310 people who are shot every day, an average of 21 are children and teens. — Of the 103 people who die, 63 are suicides, one death is unintentional, one is by legal intervention, and

one with an unknown intent. — Of the 210 people who are shot but survive, 95 are assaulted, 90 are shot accidently, ten are suicide

attempts, four are legal interventions and 12 are shot with an unknown intent.

(Source: Brady Campaign to Prevent Gun Violence, Fact Sheet, Updated on August 2020)

ENVIRONMENTAL CONDITIONS | 132

Social Conditions: Environmental Conditions Key Findings Lucas County adults reported the following as the top four issues that threatened their health in the past year: bed bugs (8%), mold (8%), insects (7%), and rodents (6%). Ten percent (10%) of adults reported they had a disaster plan in preparation of a disaster. Environmental Health • Lucas County adults thought the following threatened their or their family members’ health in the past year:

— Bed bugs (8%) — Mold (8%) — Insects (7%) — Rodents (6%) — Safety hazards (structural problems) (5%) — Plumbing problems (5%) — Air quality (4%) — Temperature regulation (heating and air

conditioning) (3%)

— Cockroaches (2%) — Unsafe water supply/wells (2%) — Sewage/wastewater problems (2%) — Moisture issues (2%) — Radon (1%) — Lice (1%) — Chemicals found in household products

(1%) — Food safety/foodborne illness (1%)

• Fifteen percent (15%) of Lucas County adults reported more than one environmental issue that threatened their or their family members’ health in the past year.

Disaster Preparedness • Lucas County households had the following disaster preparedness supplies: cell phone (86%), working

smoke detector (77%), working flashlight and working batteries (73%), computer/tablet (73%), three-day supply of nonperishable food for everyone in the household (51%), three-day supply of prescription medication for each person who takes prescribed medicines (49%), working carbon monoxide detector (48%), three-day supply of water for everyone in the household (one gallon of water per person per day) (38%), working battery-operated radio and working batteries (33%), home land-line telephone (30%), communication plan (25%), generator (10%), and disaster plan (8%).

• Eighty-eight percent (88%) of Lucas County adults reported having more than one disaster preparedness supply. Eleven percent (11%) reported having none of the above disaster preparedness supplies.

8% of Lucas County adults, or approximately 3,391 adults reported that bed bugs threatened their or their family members’ health in the past year.

Mold Prevention Tips

• Exposure to damp and moldy environments may cause a variety of health effects. Some people are sensitive to molds. For these people, exposure to molds can lead to symptoms such as stuffy nose, wheezing, and red or itchy eyes, or skin. Some people, such as those with allergies to molds or with asthma, may have more intense reactions.

• In your home, you can control mold growth by: — Keeping humidity levels as low as you can, no higher than 50%, all day long. — Making sure your home has enough ventilation. Use exhaust fans which vent outside your home in the

kitchen and bathroom. Make sure your clothes dryer vents outside your home. — Fixing any leaks in your home’s roof, walls, or plumbing so mold does not have moisture to grow. — Not using carpet in rooms or areas like bathrooms or basements that may have a lot of moisture.

(Source: CDC, Basic Facts about Mold and Dampness, Updated August 11, 2020)


Health Care Access: African American Health Care Coverage Key Findings In 2020, 11% of Lucas County African American adults were without health care coverage. Those most likely to be uninsured were females and those with annual incomes less than $25,000.

Health Care Coverage • In 2020, 89% of Lucas County African American adults had health care coverage, and 11% were uninsured. • Seventeen percent (17%) of Lucas County African American adults with children did not have health care

coverage, compared to 7% of those who did not have children living in their household.

• The following reasons were cited by uninsured Lucas County African American adults as reasons for being without health care coverage: 1. Became a part time or temporary employee (28%) 2. Cost (28%) 3. Lost their jobs or changed employers (18%) 4. Do not think they needed it (13%)


• The following types of health care coverage were used: employer (36%); Medicare (25%); Medicaid or medical assistance (19%); someone else’s employer (6%); self-purchased plan (5%); multiple, including government insurance (3%); multiple, including private insurance (3%); and Health Insurance Marketplace (2%).

• Lucas County African American adults had the following issues regarding their health care coverage: — Cost (32%) — Opted out of certain coverage because they could not afford it (11%) — Could not understand their insurance plan (9%) — Provider was no longer covered (6%) — Service no longer covered (6%) — Limited visits (5%) — Service not deemed medically necessary (3%) — Working with their insurance company (2%) — Pre-existing conditions (2%) — Opted out of certain coverage because they did not need it (2%)

Adult Comparisons


American 2007


American 2011


American 2014


American 2017


American 2020

Ohio African

American 2018

U.S. African

American 2018

Uninsured 12% 25% 25% 3% 11% 10% 14%

In Lucas County, 11% of African American adults were uninsured.


The following graph shows the percentage of Lucas County African American adults who were uninsured. An example of how to interpret the information includes: 11% of all Lucas County African American adults were uninsured, including 10% of African American adults with annual incomes less than $25,000 and 2% of those older than the age of 65. The pie chart shows sources of Lucas County African American adults’ health care coverage.


Employer, 36%

Medicare, 25%

Medicaid, 19%

Self-purchased, 5%



Multiple, including private insurance,

3%

Multiple, including government

insurance, 3%

Source of Health Coverage for Lucas County African American Adults

11%

8%

13%

8%

2%

10%

6%

25% 25%

3%

0%

10%

20%

30%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Who Were Uninsured


The following chart shows what is included in Lucas County African American adults’ insurance coverage.


Medical 97% 2% 1%



87% 4% 9%


86% 2% 12%


Dental 84% 15% 1%








40% 8% 52%

Hospice 33% 10% 57%

Healthy People 2020

Access to Health Services (AHS)*

Note: U.S. baseline is age-adjusted to the 2000 population standard. (Sources: Healthy People 2020 Objectives, 2018 BRFSS, 2019/2020 Lucas County Health Assessment) *Ohio/U.S. percentages, and Healthy People 2020 targets are not race specific Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey

Objective


Americans 2020

Ohio 2018*

U.S. 2018*

Healthy People 2020

Target

AHS-1.1: Persons under age of 65 years with health insurance




100%


Health Care Access: African American Access and Utilization

Key Findings One-fifth (20%) of African American adults did not get their prescriptions from their doctors filled in the past year. Twenty-one percent (21%) of African American adults looked for a program to help with depression, anxiety, or some mental health problem.

Health Care Access and Utilization • In 2020, African American adults usually visited the following places for health care services when they were

sick or needed advice: — Doctor’s office (87%) — Urgent care center (35%) — Hospital emergency room (35%) — Family and friends (18%) — Internet (15%) — Called 9-1-1/used an ambulance service (8%) — In-store health clinic (6%) — Community health center (4%) — Chiropractor (3%) — Alternative therapies (2%) — Veterans Affairs (VA) (2%) — Telemedicine (2%) — Some other place (2%) — Three percent (3%) of African American adults indicated they had no usual place for health care services.

• The following prevented Lucas County African American adults from getting medical care in the past year: no

need to go (38%), cost/no insurance (13%), doctor would not take their insurance (3%), too embarrassed to seek help (3%), no transportation (3%), office was not open when they could get there (3%), too long of a wait for an appointment (3%), and some other reason (18%).

• Lucas County African American adults went outside of Lucas County for health care services for the following

reasons: service was not available locally (1%), had a bad experience locally (1%), and other (4%). • One-fifth (20%) of Lucas County African American adults did not get their prescriptions from their doctors

filled in the past year for the following reasons: too expensive (52%), did not think they needed it (48%), no insurance (28%), they did not have any prescriptions to be filled (20%), side effects (16%), no generic equivalent of what was prescribed (16%), stretched current prescription by taking less than what was prescribed (12%), and fear of addiction (8%).


to make decisions for themselves. Thirteen percent (13%) of Lucas County African American adults reported they had a living will, increasing to 18% of those with annual incomes less than $25,000 and increasing to 31% of those older than the age of 65.

• A durable power of attorney is a written legal document in which people name an individual who will make

medical decisions for them when they are unable to do so. Ten percent (10%) of Lucas County African American adults had a durable power of attorney, increasing to 19% of those over the age of 65.

• Of the Lucas County African American adults who did not have a living will or durable power of attorney, 38%

had discussed their medical wishes with a family member or loved one.

During the past year, 13% African American adults did not receive medical care due to cost/no insurance.


Availability of Services

Lucas County African American Adults Able to Access Assistance Programs/Services


Types of Programs (% of all African American adults who looked for the programs)

Lucas County African American adults who have looked but have NOT found a specific program

Lucas County African American adults who have looked and have found a specific program


41% 59%


55% 45%


25% 75%


25% 75%


22% 78%


75% 25%


14% 86%


50% 50%


17% 83%


17% 83%


17% 83%


60% 40%


20% 80%


20% 80%


50% 50%


50% 50%


50% 50%


33% 67%

Gambling abuse (1% of all adults looked)

100% 0%

PREVENTIVE HEALTH | 138

Health Care Access: African American Preventive Medicine Key Findings More than half (55%) of Lucas County African American adults had a flu vaccine during the past year. More than two-thirds (70%) of African American adults ages 65 and older had a pneumonia vaccination at some time in their life.

Preventive Medicine

• More than half (55%) of Lucas County African American adults had a flu vaccine during the past year, increasing to 76% of those 65 and older.

• More than one-third (37%) of African American adults have had a pneumonia shot in their life, increasing to 70% of those ages 65 and over.

• Lucas County African American adults have had the following vaccines: — Measles, mumps, and rubella (MMR) in their lifetime (73%) — Chicken pox in their lifetime (72%) — Tetanus booster (Td/Tdap) in the past ten years (62%) — Hepatitis B vaccine in their lifetime (36%) — Hepatitis A vaccine in their lifetime (34%) — Zoster (shingles) vaccine in their lifetime (23%) — Influenza type B vaccine in their lifetime (22%) — Meningococcal vaccine in their lifetime (22%) — Human papillomavirus (HPV) vaccine in their lifetime (18%)


• In the past year, 55% of Lucas County African American women ages 40 and older had a mammogram.

• In the past year, 28% of African American men ages 50 and older had a digital rectal exam.

• See the Women’s and Men’s Health Sections for further prostate, mammogram, clinical breast exam, and Pap smear screening test information for Lucas County African American adults.

Lucas County African American Adult Health Screening Results






Survived a Stroke 4% *Percentages based on all Lucas County African American adults surveyed.


Health Care Topics Discussed by Lucas County African American Adults With Their Health Care Professional in the Past Year


Total 2020

Alcohol use 3% 13%

Child care N/A 4%

Depression, anxiety, or emotional problems 21% 30%

Domestic violence 2% 3%

Drug abuse 3% 9%

E-cigarettes/vaping N/A 4%

Education N/A 7%

Family history 21% 32%

Family planning 7% 12%

Financial strains N/A 7%

Food access N/A 11%

Housing N/A 7%

Immunizations 22% 24% Injury prevention (e.g., safety belt use, helmet use & smoke detectors)

7% 14%


7% 14%

Safe use of prescription medication 20% 26%

Sexually transmitted diseases (STDs) 4% 12%

Social connections N/A 9%

Tobacco use 14% 19%

Training and employment N/A 6%

Transportation N/A 7%

Utilities N/A 5%

Weight control (e.g., diet, physical activity) 38% 33% N/A – Not Available

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


44% 55% 51% 71% 70% 69% 60%

Had a flu vaccine in the past year

28% 28% 40% 59% 55% 31% 28%


46% 67% 55% 73% 76% 52% 47%

Ever had a shingles or zoster vaccine

N/A N/A N/A 12% 23% N/A N/A



The following graph shows the percentage of Lucas County African American adults who received a flu vaccine within the past year. Examples of how to interpret the information shown on the graph include: 55% of Lucas County African American adults received a flu vaccine within the past year, including 59% of African American females and 66% of those with annual incomes less than $25,000.


Healthy People 2020

Immunization and Infectious Diseases (IID)*

Note: U.S. baseline is age-adjusted to the 2000 population standard. *Healthy People target is not race specific (Sources: Healthy People 2020 Objectives, 2019/2020 Lucas County Health Assessment)

Objective


Americans 2020

Healthy People 2020

Target


70% 90%


76% 90%


23% 30%

55%

46%

59%

50%

76%

66%

50%

28%

40%

59%

0%

20%

40%

60%

80%

100%


2020


Income $25KPlus


2011


2014


2017

Lucas County African American Adults who Received a Flu Vaccine Within the Past Year


Health Care Access: African American Women’s Health Key Findings In 2020, over half (55%) of Lucas County African American women older than the age of 40 reported having a mammogram. Sixty-one percent (61%) of Lucas County African American women had a clinical breast exam, and 44% had a Pap smear to detect cancer of the cervix, in the past year. More than half (53%) had high blood pressure, 44% were obese, 30% had high blood cholesterol, and 22% were identified as current smokers, all known risk factors for cardiovascular diseases.


• More than three-fourths (77%) of Lucas County African American women had a mammogram at some time in their life, and almost half (48%) had this screening in the past year.

• More than half (55%) of Lucas County African American women ages 40 and older had a mammogram in the past year, and 76% had one in the past two years.

• Most (94%) Lucas County African American women had a clinical breast exam at some time in their life, and 61% had one within the past year. More than three-fifths (68%) of African American women ages 40 and older had a clinical breast exam in the past two years.

• Ninety-nine percent (99%) of Lucas County African American women had a Pap smear at some time in their life, and 44% reported having had the exam in the past year. Seventy percent (70%) of African American women had a Pap smear in the past three years. Ten percent (10%) African American women reported the screening was not recommended by their doctor.

Pregnancy • Fifteen percent (15%) of Lucas County African American women had been pregnant in the past five years. • Thinking back to their last pregnancy, 64% of Lucas County African American women did not want to be

pregnant then or any time in the future, 27% wanted to be pregnant then, and 9% did not recall.


• Lucas County African American women used the following as their usual source of services for female health concerns: private gynecologist (44%), general or family physician (35%), family planning clinic (4%), and emergency room (1%). Twelve percent (12%) of African American women indicated they did not have a usual source of services for female health concerns.


pressure, physical inactivity, and diabetes. In 2020, the health assessment identified that: 82% of African American women were overweight or obese — 53% of African American women were diagnosed with high blood pressure — 30% of African American women were diagnosed with high blood cholesterol — 22% of African American women were current smokers — 15% of African American women had been diagnosed with diabetes

Lucas County African American Female Leading Causes of Death, 2016 – 2018

Total Lucas County African American Female Deaths: 1,199

1. Heart Diseases (24% of all deaths) 2. Cancers (21%) 3. Stroke (7%) 4. Alzheimer’s Disease (5%) 5. Accidents, Unintentional Injuries (5%)

(Source: Ohio Public Health Warehouse, 2016-2018)

Ohio African American Female Leading Causes of Death, 2016 – 2018

Total Ohio African American Female Deaths: 20,100

1. Heart Diseases (22% of all deaths) 2. Cancers (21%) 3. Stroke (6%) 4. Accidents, Unintentional Injuries (4%) 5. Diabetes (4%)



The following graph shows the percentage of Lucas County African American women that had various health exams in the past year. An example of how to interpret the information includes: 48% of Lucas County African American females had a mammogram within the past year, 61% had a clinical breast exam, and 44% had a Pap smear.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup

is higher than that of the overall survey.

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


78% 79% 74% 81% 68% 83% N/A


78% 76% 79% 80% 76% 81% 78%


N/A N/A 78%* 77%* 77% N/A 85%

N/A – Not Available *Previous Lucas County trend data included women of all ages

48%

38%

55%

42%

57%49% 49%

61%

88%

48% 50%

71%

53%60%

44%

75%

24%32%

54%

42%50%

0%

20%

40%

60%

80%

100%

Total Under 40 40 & Older Income <$25K Income >$25K Lucas AfricanAmerican 2014


Lucas County African American Women's Health Exams Within the Past Year


Cancer Disparities Among African American Women

Cancer affects all population groups in the United States, but certain groups may bear a disproportionate burden of cancer compared with other groups. Although cancer incidence and mortality overall are declining in all racial/ethnic groups in the United States, certain groups continue to be at increased risk of developing or dying from particular cancers. For example:

• African American women are much more likely than white women to die of breast cancer, and the mortality gap is widening. In the past, the incidence rate of breast cancer in African American women was lower in white women, but it has now caught up.

• African American women are nearly twice as likely as white women to be diagnosed with triple-negative breast cancer, which is more aggressive and harder to treat than other subtypes of breast cancer.

(Source: National Cancer Institute, Cancer Disparities, March 11, 2019)

MEN’S HEALTH | 143

Health Care Access: African American Men’s Health

Key Findings More than three fourths (76%) of Lucas County African American men had a digital rectal exam in their lifetime, and 22% had one in the past year. More than half (57%) of Lucas County African American men had been diagnosed with high blood pressure, 31% had high blood cholesterol, and 18% were identified as smokers, which, along with obesity (43%), which are all known risk factors for cardiovascular diseases.


• More than three-fourths (76%) of Lucas County African American men had a digital rectal exam in their lifetime, and 22% had one in the past year.



smoking, obesity, high blood cholesterol, high blood pressure, physical inactivity, and diabetes. In 2020, the health assessment identified that: — 74% of Lucas County African American men were

overweight or obese 57% of Lucas County African American men were diagnosed with high blood pressure 31% of Lucas County African American men diagnosed with high blood cholesterol 18% of Lucas County African American men were current smokers 16% of Lucas County African American men had been diagnosed with diabetes

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


37% 34% 21% 7% 22% N/A N/A


Lucas County African American Male Leading Causes of Death, 2016 – 2018

Total Lucas County Male Deaths: 1,344

1. Heart Diseases (25% of all deaths) 2. Cancers (21%) 3. Accidents, Unintentional Injuries (8%) 4. Diabetes (5%) 5. Assault, Homicide (5%) (Source: Ohio Public Health Warehouse, 2016-2018)

Ohio African American Male Leading Causes of Death, 2016 – 2018

Total Ohio Male Deaths: 21,840

1. Heart Diseases (22% of all deaths) 2. Cancers (20%) 3. Accidents, Unintentional Injuries (9%) 4. Assault, Homicide (6%) 5. Diabetes (5%)



The following graphs show the percentage of Lucas County African American males that had digital rectal exams in the past year. Examples of how to interpret the information include: 22% of Lucas County African American males had a digital rectal exam within the past year, including 28% of those aged 50 and older and 25% of those with annual incomes less than $25,000.


22%

14%

28%25%

22%

34%

21%

7%

0%

10%

20%

30%

40%


Under 50 50 & Older Income<25K

Income$25K Plus




Lucas County African American Men's Digital Rectal Exams Within the Past Year

American Cancer Society Recommendations for Prostate Cancer Early Detection

The American Cancer Society recommends that men have a chance to make informed decisions with their health care provider about being screened for prostate cancer. The decision should be made after getting information about risks and benefits of prostate cancer screenings. Men should not be screened unless they have received this information. Men at high risk of developing prostate cancer (Black men and those with a close relative diagnosed with prostate cancer before the age of 65) should have this discussion beginning at age 45, and men at even higher risk (those with several close relatives diagnosed at an early age) should have this discussion beginning at 40.

After this discussion, men who want to be screened should get the prostate-specific antigen (PSA) blood test. The digital rectal exam may also be done as a part of screening.

(Source: American Cancer Society, Recommendations for Prostate Cancer Early Detection, 2020)

ORAL HEALTH | 145

Health Care Access: Oral Health Key Findings Forty-four percent (44%) of Lucas County African American adults visited a dentist or dental clinic in the past year. Eleven percent (11%) of African American adults did not see a dentist in the past year due to cost.

Oral Health • In the past year, 44% of Lucas County African American adults had visited a dentist or dental clinic, decreasing

to 26% of those with annual incomes less than $25,000.

• Forty-three percent (43%) of Lucas County African American adults with dental insurance had been to the dentist in the past year, compared to 10% of those without dental insurance.

• Lucas County African American adults reported the following reasons for not visiting a dentist in the last year: — Fear, apprehension, nervousness, pain, and dislike going (19%) — Had dentures (16%) — No reason to go/had not thought of it (14%) — Cost (11%) — Did not have/know a dentist (4%) — Transportation (2%) — Could not find a dentist taking Medicaid patients (1%) — Other reasons (11%)

• Lucas County African American adults completed the following oral health habits daily: brushed their teeth

(94%), used mouth wash (57%), and flossed their teeth (52%).

• Lucas County African American adults had the following oral health issues: pain (11%), difficulty eating/chewing (10%), loose teeth (8%), problems with dentures (7%), no teeth (7%), oral bleeding (6%), skipped meals due to pain (5%), missed work due to mouth pain (5%), and other (17%). Sixteen percent (16%) of adults reported experiencing two or more oral health issues.

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Visited a dentist in the past year

55% 60% 51% 63% 44% 64% 61%

African American Adult Oral Health

Within the Past

Year

Within the Past

Two Years

Within the Past

Five Years

Five or More years

Never


Males 40% 25% 8% 10% 0%

Females 47% 26% 11% 10% 1%

Total 44% 26% 10% 11% 1%

During the past year, 44% of Lucas County African American adults visited a dentist or dental clinic.

ORAL HEALTH | 146

The following graph provides information about the frequency of Lucas County African American adult dental visits. Examples of how to interpret the information include: 44% of Lucas County African American adults had been to the dentist or dental clinic in the past year, including 47% of African American females and 26% of those with annual incomes less than $25,000.


44%40%

47%51%

35%

26%

60% 60%

51%

63%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Who Visited a Dentist or Dental Clinic in the Past Year

Disparities in Oral Health

Oral health disparities are profound in the Unites States. Despite major improvements in oral health for the population as a whole, oral health disparities exist for racial and ethnic groups, socioeconomic status, gender, age, and geographic location. Behavioral factors that contribute to these differences include tobacco use, alcohol use, and poor dietary choices. The economic factors that often relate to poor oral health include access to health services and an individual’s ability to get and keep dental insurance.

— Overall: Non-Hispanic Blacks, Hispanics, and American Indians and Alaska Natives generally have the poorest oral health of any racial and ethnic group in the U.S.

— Adults and untreated tooth decay: Blacks, non-Hispanics, and Mexican Americans aged 35-44 years experience untreated tooth decay nearly twice as much as non-Hispanic whites

— Adults and oral cancer: The 5-year survival rate is lower for oral cancers among Black men than whites (35% versus 61%)

— Tooth decay and education: Adults aged 35-44 years with less than a high school education experience untreated tooth decay nearly three times as much as adults with at least some college education.

(Source: Centers for Disease Control and Prevention, Disparities in Oral Health, May 1, 2020)


Health Behaviors: African American Health Status Perceptions Key Findings In 2020, 36% of Lucas County African American adults rated their health status as excellent or very good. Conversely, 25% of Lucas County African American adults described their health as fair or poor, increasing to 33% of those with incomes less than $25,000. General Health Status • Thirty-six percent (36%) of Lucas County African American adults rated their health as excellent or very good.

Lucas County African American adults with higher incomes (52%) were most likely to rate their health as excellent or very good, compared to 17% of those with incomes less than $25,000.

• One quarter (25%) of Lucas County African American adults rated their health as fair or poor. • Lucas County African American adults were most likely to rate their health as fair or poor if they:

— Had been diagnosed with diabetes (38%) — Were 65 years of age or older (37%) — Had an annual household income under $25,000 (33%) — Were female (30%) — Had high blood pressure (29%)

The following graph shows the percentage of Lucas County African American adults who described their personal health status as excellent/very good, good, and fair/poor. Examples of how to interpret the information include: 36% of Lucas County African American adults, 38% of females, and 18% of those ages 65 and older rated their health as excellent or very good.


25% of Lucas County African American adults rated their general health as fair or poor.

36% 31%38% 37%

18% 17%

51%

36%29%

44%

39% 53%32% 37%

45% 50%

30%

39%42%

36%

25%16%

30% 26%37% 33%

19%25% 29%

20%

0%

20%

40%

60%

80%

100%


2020

Males Females 30-64 years 65 & Over Income<$25K

Income $25KPlus


2011


2014


2017

Lucas County African American Adult Health Perceptions*




• More than one-quarter (30%) of Lucas County African American adults rated their physical health as not good on four or more days in the previous month.

• Lucas County African American adults reported their physical health as not good on an average of 4.9 days in the previous month.

• Lucas County African American adults were most likely to rate their physical health as not good (on four or

more days during the past month) if they: — Had an annual household income under $25,000 (76%) — Were 65 years of age or older (62%) — Were male (57%)

Mental Health Status • Forty-three (43%) of Lucas County African American adults rated their mental health as not good on four or

more days in the previous month. • Lucas County African American adults reported their mental health as not good on an average of 6.1 days in

the previous month.

• Thirty-four percent (34%) of Lucas County African American adults reported that poor mental or physical health kept them from doing usual activities such as self-care, work, or recreation.

• Lucas County African American adults were most likely to rate their mental health as not good (on four or more

days during the past month) if they: — Had an annual household income under $25,000 (67%) — Were male (50%) — Were 65 years of age or older (49%)

The table shows the percentage of African American adults with poor physical and mental health in the past 30 days.


African American Health Status

No Days 1-3 Days 4-5 Days 6-7 Days 8 or More Days

Physical Health Not Good in Past Month*

Males 43% 10% 12% 6% 20% Females 47% 12% 7% 4% 16%

Total 45% 12% 9% 5% 17% Mental Health Not Good in Past Month*

Males 50% 4% 4% 0% 33% Females 40% 13% 8% 3% 22%

Total 44% 9% 6% 2% 26%



*County Health Rankings

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Rated health as excellent or very good

37% 36% 29% 44% 36% 43% 44%

Rated general health as fair or poor

25% 26% 29% 20% 25% 23% 21%


30% 29% 32% 33% 43% 29% 26%

Average number of days that mental health was not good (in the past month)

N/A N/A N/A 6.0 6.1 N/A N/A


31% 34% 22% 26% 30% 24% 23%

Average number of days that physical health not good (in the past month)

N/A N/A N/A 6.5 4.9 N/A N/A


N/A N/A N/A 38% 34% 24% 25%

WEIGHT STATUS | 150

Health Behaviors: African American Adult Weight Status

Key Findings Nearly four-fifths (79%) of Lucas County African American adults were overweight or obese based on body mass index (BMI). Twenty-nine percent (29%) of African American adults did not participate in any physical activity in the past week, including 2% who were unable to exercise.

Adult Weight Status

• Nearly four-fifths (79%) of Lucas County African American adults were either overweight (34%) or obese (45%) by body mass index (BMI), putting them at elevated risk for developing a variety of diseases.

• More than two-fifths (46%) of Lucas County African American adults were trying to lose weight, 24% were trying to maintain their current weight or keep from gaining weight, and 2% were trying to gain weight.

• Lucas County African American adults did the following to lose weight or keep from gaining weight in the past month: exercised (34%); drank more water (34%); ate less food, fewer calories, or foods low in fat (33%); ate a low-carb diet (12%); used a weight loss program (3%); used health coaching (3%); took diet pills, powders or liquids without a doctor’s advice (2%); participated in a prescribed dietary or fitness program (2%); went without eating 24 or more hours (2%); took prescribed medications (2%); took laxatives (2%); smoked cigarettes (1%); had bariatric surgery (1%); vomited after eating (1%) and other (4%).

• Lucas County African American adults spent an average of 4.0 hours watching TV, 2.4 hours on their cell phone,

1.4 hours on their PC/tablet, and 0.5 hours playing video games on an average day of the week. The following graph shows the percentage of Lucas County African American adults who are overweight or obese by body mass index (BMI). Examples of how to interpret the information include: 21% of all Lucas County African American adults were classified as normal weight, 34% were overweight, and 45% were obese.


45% of Lucas County African American adults were obese.

21% 25%18% 13% 17% 13%

23% 24% 23%14%

34% 32%38%

32%32%

31%

30% 28% 35%

27%

45% 43% 44%55% 51% 56%

47% 47% 39%58%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020

Male Female 30-64 Years 65 & Over Income <$25K

Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adult BMI Classifications*


WEIGHT STATUS | 151

Physical Activity

• In Lucas County, 50% of African American adults engaged in some type of physical activity or exercise for at least 30 minutes 3 or more days per week. Twenty-five percent (25%) of adults exercised 5 or more days per week. More than one-quarter (29%) of adults did not participate in any physical activity in the past week, including 2% who were unable to exercise.

• Lucas County African American adults spent the most time doing the following physical activities in the past year: walking (31%), strength training (9%), exercise machines (5%), group exercise classes (5%), occupational exercise (4%), running/jogging (2%), exercise videos (1%) and other (5%). Twenty percent (20%) of adults engaged in multiple types of exercise.

• Lucas County African American adults reported the following would help them use community parks, bike trails, and walking paths more frequently: — More accessible parks, bike trails, and walking paths (38%) — Designated safe routes (31%) — Improvements to existing parks, trails, and paths (27%) — More public events and programs involving parks, trails, and paths (20%) — Better promotion and advertising of existing parks, trails, and paths (18%)

• Lucas County African American adults reported the following reasons for not exercising: time (38%); laziness (32%); self-motivation/will power (28%); pain or discomfort (23%); too tired (23%); weather (18%); choose not to exercise (18%); do not like to exercise (17%); afraid of injury (13%); could not afford a gym membership (13%); no exercise partner (11%); ill or physically unable (8%); no walking, biking trails, or parks (6%); lack of opportunities for those with physical impairments or challenges (4%); too expensive (3%); neighborhood safety (3%); did not know what activity to do (3%); no gym available (1%); poorly maintained/no sidewalks (1%); no child care (1%); no transportation to a gym of other exercise opportunity (1%); other (14%); and doctor advised them not to exercise (1%).

Nutrition The table below indicates the number of servings of fruit, vegetables, sugar-sweetened beverages, and caffeinated beverages Lucas County African American adults consumed daily.

5 or more servings

daily

3-4 servings

daily

1-2 Servings

daily

0 servings

daily

Fruit 1% 17% 73% 9%




Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Overweight (BMI of 25.0 – 29.9)

37% 28% 35% 27% 34% 34% 33%


44% 47% 39% 58% 45% 36% 40%

WEIGHT STATUS | 152

• In 2020, 30% of Lucas County African American adults ate 1 to 2 servings of fruits and/or vegetables per day, 40% ate 3 to 4 servings per day, and 27% ate 5 or more servings per day. Three percent (3%) of adults ate no servings of fruits and vegetables per day.

• Lucas County African American adults reported they obtain their fresh fruits and vegetables from the following: — Large grocery store (such as Wal-Mart, Meijer, Kroger) (92%) — Farmers market (43%) — Local grocery store (such as Save-A-Lot) (34%) — Grow their own/garden (12%) — Food pantry (8%) — Dollar general/store (6%) — Corner/convenience stores (3%) — Community garden (2%) — Veggie mobile/mobile produce (2%) — Other (6%)

• Lucas County African American adults reported the following barriers to consuming fruits and vegetables: too expensive (10%), did not have access to fruits and vegetables (3%), did not like the taste (2%), did not know how to prepare (1%), no variety (1%), stores did not take EBT (1%), and other barriers (7%).

• Lucas County African American adults reported the following reasons they chose the types of food they ate: — Taste/enjoyment (53%) — Cost (49%) — Healthiness of food (44%) — Ease of preparation/time (31%) — Nutritional content (24%) — Availability (19%) — Calorie content (18%) — What their family prefers (16%) — If it is lactose free (12%) — If it is organic (9%) — Artificial sweetener content (6%) — Health care provider’s advice (6%) — Availability at food panty (6%) — Limitations due to dental issues (5%) — If it is gluten free (4%) — Other food sensitivities (4%) — Limitations set by WIC (4%) — If it is genetically modified (3%) — Other reasons (10%)

TOBACCO USE | 153

Health Behaviors: African American Adult Tobacco Use Key Findings In 2020, 21% of Lucas County African American adults were current smokers, and 18% were considered former smokers. Three percent (3%) of African American adults used e-cigarettes or vapes in the past year.

Adult Tobacco Use Behaviors • Twenty-one percent (21%) of Lucas County African American adults were current smokers (those who indicated

smoking at least 100 cigarettes in their lifetime and currently smoked some or all days). • Nearly one-fifth (18%) of Lucas County African American adults indicated that they were former smokers

(smoked 100 cigarettes in their lifetime and now do not smoke). • Lucas County African American adult smokers were more likely to have:

— Incomes less than $25,000 (33%) — Been ages 30-64 (28%) — Been female (22%)

• Lucas County African American adults used the following tobacco products in the past year: cigarettes (22%);

cigars (6%); little cigars (6%); cigarillos (4%); e-cigarette/vapes (3%); and chewing tobacco, snuff, or snus (3%). • Sixty-three percent (63%) of Lucas County African American current smokers responded that they had stopped

smoking for at least one day in the past year because they were trying to quit smoking.

• Lucas County African American adults had the following rules/practices about smoking tobacco in their home: allowed anywhere in their home (21%), allowed only in certain rooms (8%), and not allowed with children around (21%). Lucas County adults had the following rules/practices about smoking tobacco in their car: allowed inside their car (10%), not allowed inside the car (69%), allowed only when one or more windows are open (11%), and not allowed with children around (15%).

• Lucas County African American adults had the following rules/practices about using e-cigarettes/vapes in their

home: allowed only in certain rooms (8%), not allowed with children around (23%), and allowed anywhere (17%). Lucas County adults had the following rules/practices about using e-cigarettes/vapes in their car: allowed inside their car (7%), never allowed (64%), allowed only when one or more windows are open (6%), and not allowed with children around (9%).

• Lucas County African American adults reported they would support an ordinance to ban smoking in the

following places: — Vehicle with a minor present (71%) — Multi-unit housing (50%) — Parks or ball fields (48%) — College/university campuses (46%) — Fairgrounds (39%) — Rental homes (37%)

• Twenty-six percent (26%) of Lucas County African American adults reported they would not support an ordinance to ban smoking anywhere.

21% of Lucas County African American adults were current smokers.

TOBACCO USE | 154

• Lucas County African American adults indicated e-cigarette or other electronic product vapor is harmful to the following: themselves (65%), an unborn child (53%), others (51%), children (49%), and not harmful to anyone (1%).

• More than one-third (36%) of adults did not know if e-cigarettes or other electronic product vapor was harmful to anyone.

The following graph shows Lucas County African American adults’ smoking behaviors. Examples of how to interpret the information include: 21% of all Lucas County African American adults were current smokers, 18% of all adults were former smokers, and 61% had never smoked.



Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


26% 25% 33% 17% 21% 24% 17%


20% 17% 15% 18% 18% 18% 15%

Tried to quit smoking N/A N/A N/A 67% 63% 63% 69%


N/A N/A N/A 1% 3% N/A N/A


21% 17% 22%28%

10%

33%

11%25%

33%

17%

18%16%

20%19%

34%

16%

21%

17%15%

18%

61%67%

58% 53% 56% 51%

68%58%

52%65%

0%

20%

40%

60%

80%

100%






2017

Lucas County African American Adult Smoking Behaviors*



Health Behaviors: Adult Alcohol Consumption Key Findings Nearly half (46%) of Lucas County African American adults had at least one alcoholic drink in the past month. One-fifth (20%) of African American adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers. Adult Alcohol Consumption • Nearly half (46%) of Lucas County African American adults had at least one alcoholic drink in the past month,

increasing to 41% of males and 59% of those with incomes less than $25,000. • Of those who drank, Lucas County African American adults drank 4.1 drinks on average. • One-fifth (20%) of Lucas County African American adults reported they had five or more alcoholic drinks (for

males) or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers. Of those who drank in the past month, 47% had at least one episode of binge drinking.

• Five percent (5%) of Lucas County African American adults reported driving after having perhaps too much

alcohol to drink in the past month, increasing to 9% of those ages 30-64.

• Lucas County African American adults reported they or a family member experienced the following during the past six months: — Had to drink more to get same effect (6%) — Drank more than they expected (5%) — Spent a lot of time drinking (5%) — Continued to drink despite problems caused by drinking (5%) — Used prescription drugs while drinking (4%) — Gave up other activities to drink (3%) — Drank to ease withdrawal symptoms (3%) — Placed themselves or their family in harm (3%) — Tried to quit or cut down, but couldn’t (2%) — Drove vehicle or other equipment after having any alcoholic beverage (2%) — Had legal problems (1%)

• Reasons African American adults did not use a program or service to help with an alcohol problem for

themselves or a loved one included the following reasons: had not thought of it (7%), transportation (4%), programs were full (3%), fear (3%), did not have any openings (wait-listed) (3%), do not want to miss work (3%), stigma of seeking alcohol services (1%), and other (17%). Seventy-six percent (76%) of adults indicated that they did not need a program or service to help with an alcohol problem for themselves or a loved one.

46% of Lucas County African American adults were considered current drinkers.



Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


40% 43% 46% 42% 46% 49% 47%


N/A 21% 21% 32% 20% 18% 13%




The following graph shows the percentage of Lucas County African American adults consuming alcohol in the past month. Examples of how to interpret the information include: 51% of all Lucas County African American adults did not drink alcohol in the past month, including 57% of males and 47% of females.

*Percentages may not equal 100% as some respondents answered, “Don’t know.” Note for graph: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey.

51% 57%47% 51%

60% 57%

40%

57%45%

58%

15%13%

17%18%

10% 18%

16%

14%19%

21%

31% 28% 32% 27% 25% 21%

43%29% 27%

21%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Average Number of Days Drinking Alcohol in the Past Month*


DRUG USE | 158

Health Behaviors: African American Adult Drug Use

Key Findings In 2020, 11% of Lucas County African American adults had used recreational marijuana during the past 6 months. Nine percent (9%) of African American adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past six months.

Adult Drug Use

• Lucas County African American adults reported that they and/or an immediate family member/someone in their household used the following in the past 6 months: — Recreational marijuana or hashish (17%) — Wax, oil with THC edibles (14%) — Medical marijuana (7%) — Amphetamines, methamphetamine or speed (7%) — LSD, mescaline, peyote, psilocybin, DMY, or mushrooms (3%) — Cocaine, crack, or coca leaves (2%) — Inappropriate use of over-the-counter medications (2%) — Heroin/fentanyl (2%) — Ecstasy, E, or GHB (2%) — Inhalants (2%) — Synthetic marijuana/k2 (2%) — Bath salts (2%)

• Eleven percent (11%) of Lucas County African American adults reported using recreational marijuana or hashish in the past 6 months.

• Lucas County African American adults reported that they and/or an immediate family member/someone in their household took the following medications not prescribed to them to feel good, high and/or more active or alert during the past six months: — Tranquilizers such as Valium or Xanax (6%) — Codeine, Demerol, Morphine, Percocet, Dilaudid, or Fentanyl (5%) — Suboxone or Methadone (5%) — Ritalin, Adderall, Concerta, or other ADHD medication (4%) — Neurontin (4%) — Steroids (4%) — OxyContin (3%) — Vicodin (2%) — Tramadol/Ultram (2%)

• As a result of using drugs, Lucas County African American adults indicated they or someone in their household

experienced the following: failed a drug screen (5%), placed themselves in dangerous situations (3%), regularly failed to fulfill obligations at work or home (2%), and had legal problems (1%).

• Seven percent (7%) of Lucas County African American adults who had been prescribed opioid-based medications had trouble stopping.

• African American adults did not using a program or service to help with a drug problem for themselves or a loves one for the following reasons: had not thought of it (4%), did not have any openings (wait-listed) (3%), did not want to miss work (3%), and other (6%). Ninety-two percent (92%) of adults indicated that they did not need a program or service to help with a drug problem for themselves or a loved one.

DRUG USE | 159

The following graphs indicate adult recreational marijuana use and prescription drug use in the past six months. An example of how to interpret the information on the first graph includes: 11% of Lucas County African American adults used recreational marijuana in the past six months, including 16% of females and 14% of those with incomes more than $25,000.


Notes for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.


Adult Comparisons


Americans 2007


Americans 2011


Americans2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


9% 17% 20% 7% 11% N/A N/A


10% 8% 11% 11% 9% N/A N/A

Adults who used heroin in the past six months

<1% 0% 1% 1% 1% N/A N/A

11%

6%

16%

11%

2%

7%

14%

17%

20%

7%

0%

5%

10%

15%

20%

25%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adult Marijuana Use in the Past 6 Months

9%10%

9%11%

4%

15%

8% 8%

11% 11%

0%

5%

10%

15%

20%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adult Medication Misuse in the Past 6 Months

DRUG USE | 160

30.2

20.7

29.8

51.4

23.8

16.120.3

28.6

41.5

33.6

0

10

20

30

40

50

60

2014 2015 2016 2017 2018

Per

100

,000

Po

pu

lati

on

Lucas County and Ohio African American Age-Adjusted Unintentional Drug Overdose Deaths 2014-2018

Lucas County Ohio

The following graph shows the Lucas County and Ohio African American age-adjusted unintentional drug overdose deaths from 2014 to 2018.

The following graph shows the number of African American unintentional drug overdose deaths from 2014 to 2018 in Lucas County.

(Source for graphs: Ohio Public Health Data Warehouse, 2014-2018, Updated 12/11/19) Note Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.

26

17

23

40

21

0

10

20

30

40

50

2014 2015 2016 2017 2018

Nu

mb

er o

f D

eath

s

Lucas County African American Unintentional Drug Overdose Deaths, 2014-2018

Total Deaths=127


Health Behaviors: African American Adult Sexual Behavior Key Findings In 2020, 57% of Lucas County African American adults had sexual intercourse. Six percent (6%) of African American adults had more than one partner.


• Fifty-seven percent (57%) of Lucas County African American adults had sexual intercourse in the past year.

• Six percent (6%) of Lucas County African American adults reported they had intercourse with more than one partner in the past year, increasing to 10% of those with incomes of $25,000 or more.

• Lucas County African American adults used the following methods of birth control: they or their partner was

too old to get pregnant (22%); male or female condoms (16%); female sterilization (tubes tied) (11%); withdrawal (7%); hysterectomy (6%); practicing abstinence (5%); birth control pills, any kind (4%); they or their partner was infertile (4%); male sterilization (vasectomy) (2%); contraceptive ring (e.g., NuvaRing) (2%); foam, jelly, film or cream (2%); had ovaries or testicles removed (1%); contraceptive implant (e.g., Nexplanon) (1%); shots (e.g., Depo-Provera) (1%); and having sex at certain times (rhythm or natural family planning) (1%).

• Seven percent (7%) of Lucas County African American adults were not using any method of birth control, 3%

were pregnant and 2% were trying to get pregnant. • The following situations applied to Lucas County African American adults: had sex without a condom in the

past year (17%); treated for an STD in the past year (4%); had anal sex without a condom in the past year (3%); tested positive for Hepatitis C (3%); injected any drug other than those prescribed in the past year (2%); was forced to have sex (1%); had sex with someone they met on social media (1%); had four or more sexual partners in the past year (1%); and engaged in sexual activity following alcohol or other drug use that they would not have done if sober (1%).

• Nine percent (9%) of Lucas County African American adults were forced or coerced to have any sexual activity when they did not want to, increasing to 16% of those with incomes less than $25,000. Eighteen percent (18%) of those who were forced to have sexual activity reported it.


Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Had more than one sexual partner in past year

20% 20% 17% 26% 6% N/A N/A


The following graph shows the number of sexual partners Lucas County African American adults had in the past year. An example of how to interpret the information includes: 51% of all African American Lucas County adults had one sexual partner in the past year, 6% had more than one partner, and 34% did not have a sexual partner.

Respondents were asked: “During the past year, with how many different people have you had sexual intercourse?” *Percentages may not equal 100% as some respondents answered, “Don’t know”.


51% 49%

38%

63%

31%

44%61%

46%54%

39%

6%4%

7%

4%

4%

4%

10%

20%17%

26%

34% 27%

38%

30%

58%

40%

29%34%

29% 31%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adult Number of Sexual Partners in the Past Year*



African American Pregnancy Outcomes Note: Pregnancy outcome data includes all births to both adults and adolescents.

• From 2014 to 2019, there was an average of 1,564 live births per year in Lucas County.

*Note: Mothers Race = African American (Source: Ohio Public Health Data Warehouse 2014-2018, Updated 8/16/2020)

1,578

1,603

1,5491,540 1,537

1,577

1,500

1,520

1,540

1,560

1,580

1,600

1,620

2014 2015 2016 2017 2018 2019

Nu

mb

er o

f Li

ve B

irth

s

Lucas County African American Total Live Births*

MENTAL HEALTH | 164

Health Behaviors: Adult Mental Health Key Findings Nine percent (9%) of Lucas County African American adults seriously considered attempting suicide in the past year. Twenty-three percent (23%) of African American adults had a period of two or more weeks when they felt sad or hopeless nearly every day that they stopped doing usual activities in the past year. Adult Mental Health • During the past year, Lucas County African American adults experienced the following almost every day for two

weeks or more in a row: did not get enough sleep or rest (39%); felt worried, tense or anxious (25%); felt sad, blue or depressed (23%); had high stress (20%); stopped during some usual activities (18%); had an unusual increase or loss of appetite (12%); and felt very healthy and full of energy (11%).

• Nine percent (9%) of Lucas County African American adults seriously considered attempting suicide in the past year.

• One percent (1%) of Lucas County African American adults reported actually attempting suicide in the past year. • Lucas County African American adults reported they or someone in their household were diagnosed with or

treated for the following mental health issues in the past year: — Depression (25%) — Anxiety or emotional problems (22%) — Anxiety disorder (panic attacks, phobia,

obsessive-compulsive disorder) (21%) — Alcohol and illicit drug abuse (10%) — Bipolar disorder (9%) — Attention deficit disorder (ADD/ADHD) (9%) — Other trauma (9%) — Post-traumatic stress disorder (PTSD) (6%)

— Eating disorder (6%) — Life adjustment disorder (4%) — Developmental disability (4%) — Autism spectrum (2%) — Psychotic disorder (schizophrenia, schizoaffective

disorder) (1%) — Gambling problem (1%) — Other mental health disorder (10%)

• Twenty-one percent (21%) of Lucas County African American adults indicated they or a family member had taken medication for one or more mental health issues.

• Lucas County African American adults dealt with stress in the following ways: prayed/meditated (55%), listened

to music (44%), talked to someone they trust (41%), exercised (39%), ate more or less than normal (33%), slept (31%), worked on a hobby (19%), worked (19%), drank alcohol (17%), smoked tobacco (11%), used prescription drugs as prescribed (11%), took it out on others (9%), used illegal drugs (5%), called a professional (4%), misused prescription drugs (3%), and other ways (11%).

• The following prevented Lucas County African American adults or someone in their household from using a program or service to help with depression, anxiety, or other emotional problems: had not thought of it (8%), fear (4%), other priorities (4%), took too long to get in to see a doctor/ health care provider (4%), could not get to the office or clinic (4%), could not find a mental health doctor or provider (4%), stigma of seeking mental health services (3%), co-pay/deductible too high (3%), did not know how to find a program (3%), transportation (1%), could not afford to go (1%), and other reasons (4%). Fifty-eight percent (58%) of adults indicated they did not need such a program.

9% of Lucas County African American adults seriously considered attempting suicide in the past year.

MENTAL HEALTH | 165

The graph below shows the number of African American suicide deaths by year in Lucas County.

(Source: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 12/11/19) Note Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


N/A 3% 5% 2% 9% N/A N/A


64

87

9

0

5

10

15

20

2014 2015 2016 2017 2018

Nu

mb

er o

f D

eath

s

Lucas County African American Number of Suicide Deaths by Year2014-2018

Total Deaths =34


Chronic Disease: African American Cardiovascular Health

Key Findings

Five percent (5%) of Lucas County African American adults had survived a heart attack and 4% had survived a stroke at some time in their life. Fifty-five percent (55%) of adults had high blood pressure, 45% were obese, 31% had high blood cholesterol, and 21% were current smokers, four known risk factors for heart disease and stroke.

Heart Disease and Stroke • Five percent (5%) of Lucas County African American adults

reported they were diagnosed with angina. • Fifty percent (50%) of those with angina were receiving

treatment for the diagnosis. • Five percent (5%) of Lucas County African American adults

reported they had a heart attack. • Fifty-seven percent (57%) of those who had a heart attack


• Four percent (4%) of Lucas County African American adults reported they had a stroke.

• Sixty percent (60%) of those who had a stroke reported

currently receiving treatment for the diagnosis.

• Five percent (5%) of Lucas County African American adults reported they had heart disease, increasing to 10% of those over the age of 65.

• Sixty-seven percent (67%) of Lucas County African American adults with heart disease were receiving treatment

for it.


• More than half (55%) of Lucas County African American adults had been diagnosed with high blood pressure. Ninety-six percent (96%) of Lucas County African American adults reported they were currently receiving treatment for the diagnosis.

• Ninety-one percent (91%) of Lucas County African American adults had their blood pressure checked within

the past year. • Lucas County African American adults diagnosed with high blood pressure were more likely to have:

— Been classified as overweight or obese by body mass index (BMI) (90%) — Been age 65 years or older (73%) — Incomes less than $25,000 (73%)

5% of African American adults survived a heart attack or myocardial infarction.

Ohio African American Leading Causes of Death

2016-2018


1. Heart Disease (22% of all deaths) 2. Cancers (20%) 3. Accidents, Unintentional Injuries (7%) 4. Stroke (5%) 5. Diabetes (4%)


Lucas County African American Leading Causes of Death

2016-2018

Total Deaths: 2,543

1. Heart Disease (24% of all deaths) 2. Cancer (21%) 3. Accidents, Unintentional Injuries (7%) 4. Stroke (6%) 5. Diabetes (5%)




• Thirty-one percent (31%) of Luas County African American adults had been diagnosed with high blood cholesterol. Seventy-eight percent (78%) of adults reported they were currently receiving treatment for the diagnosis.

• Eighty-four percent (84%) of Lucas County African American adults had their blood cholesterol checked within

the past five years. • Lucas County African American adults with high blood cholesterol were more likely to:

— Have been classified as overweight or obese by body mass index (BMI) (100%) — Have incomes less than $25,000 (53%) — Have been ages 65 years or older (46%)

The following graphs show the number of Lucas County African American adults who have been diagnosed with high blood pressure and high blood cholesterol. An example of how to interpret the information on the first graph includes: 55% of all Lucas County African American adults have been diagnosed with high blood pressure, including 57% of males and 73% of those 65 years and older.



55% 57%53%

64%73% 73%

55%

44%49%

44%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosedwith High Blood Pressure*

31% 31% 30% 31%

46%53%

20% 21% 23% 24%

0%

20%

40%

60%

80%

100%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with High Blood Cholesterol


The following graph demonstrates the percentage of Lucas County African American adults who had major risk factors for developing cardiovascular disease (CVD).

Healthy People 2020 Objectives Heart Disease and Stroke (HDS)*

Note: All U.S. figures age-adjusted to 2000 population standard. *Healthy People 2020 target is not race specific (Source: Healthy People 2020, 2017 BRFSS, 2019/2020 Lucas County Health Assessment)

Objective

2020 Lucas County African

American Survey Population

Baseline



55% 27%


84% 82%


31% 14%

55%

45%

29%

21%15%

0%

20%

40%

60%

80%


Lucas County African American Adults with Cardiovascular Disease Risk Factors


The following graph shows the percentage of Lucas County African American adults who had survived a heart attack or stroke in their lifetime by gender. An example of how to interpret the information includes: 2% of Lucas County African American males survived a stroke compared to 4% of females.


Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Had angina 10% 1% 5% 2% 5% 3% 4%

Had a heart attack N/A 1% 8% 4% 5% 5% 4%

Had a stroke N/A 2% 4% 6% 4% 6% 5% Had been diagnosed with high blood pressure

54% 44% 49% 44% 55% 40%* N/A


37% 21% 23% 24% 31% 28%* N/A


75% 69% 79% 68% 84% 88%* N/A

*2017 BRFSS data N/A – Not Available

5% 5% 5%4%

2%

4%

0%

2%

4%

6%

8%

10%

Total Male Female

Lucas County African American Adults Who Had Survived a Heart Attack or Stroke In Their Lifetime

Heart Attack Stroke


The following graphs show the age-adjusted mortality rates per 100,000 population for heart disease and stroke. • When age differences are accounted for, the statistics indicate that the Lucas County African American heart

disease mortality rate was higher than the figures for the state, the U.S., and Healthy People 2020 target from 2016 to 2018.

• The 2016 to 2018 Lucas County African American age-adjusted stroke mortality rate was higher than the

figures for the state, the U.S., and the Healthy People 2020 target. • From 2016 to 2018, the Lucas County African American female and male age-adjusted heart disease mortality

rates fluctuated.

(Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2016-2018, Healthy People 2020) *The Healthy People 2020 Target objective for coronary heart disease is reported for heart attack mortality. Healthy People 2020 targets are not

race specific


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Lucas County African American Age-Adjusted Heart Disease Mortality Rates by Gender


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African American Age-Adjusted Heart Disease and Stroke Mortality Rates



The following graph shows the age-adjusted mortality rates per 100,000 population for stroke by gender. • From 2010 to 2018, the Lucas County African American male stroke mortality decreased.


The following graph shows the age-adjusted mortality rates per 100,000 population for heart disease and stroke by race. The graph shows: • From 2016 to 2018, the age-adjusted stroke and heart disease mortality rates were higher in the African

American population than the white population.

*Races represented are white and Black. All other races were not available due to low rates.


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Lucas County African American Age-Adjusted Heart Disease and Stroke Mortality Rates by Race*, 2016-2018


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African American Age-Adjusted Stroke Mortality Rates by Gender

Lucas County 2010-2012 Lucas County 2013-2015 Lucas County 2016-2018

CANCER | 172

Chronic Disease: African American Cancer

Key Findings In 2020, 11% of Lucas County African American adults had been diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (533) of all (2,543) Lucas County African American resident deaths.

Adult Cancer • Eleven percent (11%) of Lucas County African

American adults were diagnosed with cancer at some point in their lifetime, increasing to 23% of those over the age of 65.

• Of Lucas County African American adults diagnosed

with cancer, they reported the following types: prostate (75%), breast (13%), cervical (13%), lung (8%), renal (8%), colon (8%), and other types of cancer (50%). Eight percent (8%) of adults were diagnosed with multiple types of cancer.

• Lucas County African American adults reported receiving the following cancer screenings:

— Colorectal cancer in the past five years (22%) — Oral cancer in the past year (10%) — Lung cancer in the past three years (5%) — Skin cancer in the past year (4%)

Cancer Facts • The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 21% (533) of all

(2,543) Lucas County African American resident deaths (Source: Ohio Public Health Data Warehouse, 2016-2018).


• ODH reports that lung and bronchus cancer (total deaths=77) was the leading cause of African American male

cancer deaths from 2016 to 2018 in Lucas County. Colorectal cancers caused 27 male deaths, cancer of the prostate caused 31 male deaths during the same time period (Source: Ohio Public Health Data Warehouse, 2016-2018).

• ODH reports that lung and bronchus cancer was the leading cause of African American female cancer deaths

(total deaths=67) in Lucas County from 2016 to 2018, followed by breast (total deaths=32) and colorectal cancers (total deaths=24) (Source: Ohio Public Health Data Warehouse, 2016-2018).

11% of Lucas County African American adults were diagnosed with cancer at some point in their lifetime.

Lucas County African American Incidence of Cancer, 2013-2017

All Types: 1,785 cases

• Prostate: 313 cases (18%) • Breast: 274 cases (15%) • Lung and Bronchus: 272 cases (15%) • Colon and Rectum: 178 cases (10%)

From 2016-2018, there were 533 African American cancer deaths in Lucas County.

(Source: Ohio Cancer Incidence Surveillance System, ODH

Information Warehouse, Updated 11/3/2019)

CANCER | 173

The following graph shows the Lucas County, Ohio and U.S. age-adjusted mortality rates (per 100,000 population, 2000 standard) for all types of cancer in comparison to the Healthy People 2020 objective.

(Source: Ohio Public Health Data Warehouse, CDC Wonder, Healthy People 2020)

Note: Healthy People 2020 target is not race specific

The following graph shows cancer as a percent of total deaths in Lucas County African American adults.


21% 21%

0%

5%

10%

15%

20%

25%

Male Female

Cancer as a Percent of All Total Deaths in Lucas CountyAfrican American Adults by Gender, 2016-2018

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African American Adult Age-Adjusted Mortality Rates for All Cancers and Healthy People 2020 Objective


CANCER | 174

Breast Cancer

• Sixty-one percent (61%) of Lucas County African American females reported having had a clinical breast examination in the past year.

• More than half (55%) of Lucas County African American females over the age of 40 had a mammogram in the past year.

• For women at average risk of breast cancer, recently updated American Cancer Society screening guidelines


The following graph shows the African American Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for breast cancer in comparison with the Healthy People 2020 objective.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018) *Healthy People 2020 target is not race specific

Prostate Cancer

• ODH statistics indicate that prostate cancer accounted for 11% of all African American male cancer deaths from

2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018). • No organizations presently endorse routine prostate cancer screening for men at average risk because of


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Lucas County African American Female Age-Adjusted Mortality Rates for Breast Cancer


CANCER | 175

The following graph shows the African American Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for prostate cancer in comparison with the Healthy People 2020 objective.


Lung Cancer • In Lucas County, 18% of African American male adults were current smokers and 16% were former smokers. • According to the American Cancer Society, smoking causes approximately 80% lung cancer deaths in the U.S.

Men and women who smoke are about 25 times more likely to develop lung cancer than nonsmokers (Source: American Cancer Society, Facts & Figures 2020).

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Lucas County African American Age-Adjusted Mortality Rates for Prostate Cancer


CANCER | 176

The following graphs show the African American Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for lung and bronchus cancer in comparison with the Healthy People 2020 objective, as well as by gender.

*Healthy People 2020 Target data is for lung cancer only. Healthy People 2020 target is not race specific (Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018)


Colorectal Cancer • ODH indicates that colorectal cancers accounted for 10% of all African American male and African American

female cancer deaths from 2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018).



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Lucas County African American Age-Adjusted Rates by Gender for Lung & Bronchus Cancer

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Lucas County African American Age-Adjusted Mortality Rates for Lung & Bronchus Cancer

Lucas 2016-2018 Ohio 2016-2018 U.S. 2016-2018 HP 2020 Target*

CANCER | 177

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Lucas County African American Colorectal Cancer Age-Adjusted Mortality Rates by Gender, 2016-2018

The following graphs show African American Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for colorectal cancer in comparison with the Healthy People 2020 objective, as well as by gender.

(Source: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018)


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Lucas County African American Age-Adjusted Mortality Rates for Colorectal Cancer


CANCER | 178

Lucas County African American Incidence of Cancer, 2013-2017

Types of Cancer Number of Cases Percent of Total

Incidence of Cancer Prostate 313 17.5% Breast 274 15.4% Lung and Bronchus 272 15.2% Colon & Rectum 178 10.0% Other Sites/Types 113 6.3% Kidney & Renal Pelvis 93 5.2% Pancreas 62 3.5% Non-Hodgkins Lymphoma 55 3.1% Uterus 53 3.0% Bladder 47 2.6% Leukemia 43 2.4% Multiple Myeloma 41 2.3% Liver & Intrahepatic Bile Duct 40 2.2% Thyroid 36 2.0% Stomach 36 2.0% Oral Cavity & Pharynx 35 2.0% Esophagus 20 1.1% Brain and Other CNS 20 1.1% Larynx 17 0.1% Cervix 13 0.7% Hodgkins Lymphoma 12 0.7% Ovary 11 0.6% Melanoma of Skin 1 0.1% Testis 0 0.0% Total 1,785 100%

(Source: Ohio Cancer Incidence Surveillance System, ODH Information Warehouse, Updated 2/7/20)

2019-2021 Cancer Estimates for African Americans

• New Cases — About 202,260 new cancer cases and 73,030 cancer deaths are expected to occur among

Blacks in 2019. African Americans have the highest death rate and shortest survival of any racial and ethnic group in the United States. The cause for these inequities are complex and reflect the social and economic disparities and cultural differenced that affect cancer risk, as well as differenced in access to high-quality care.

— About 98,020 cancer cases in Black men and 104,240 cases in Black women are expected to be newly diagnosed in 2019. Prostate cancer in the most commonly diagnosed cancer for Black men and breast cancer is the most commonly diagnosed in black women.

— About 1 in 3 Black men and women will be diagnosed with cancer in their lifetime.

• Deaths — About 36,840 Black men and 36,190 Black women are expected to die from cancer in 2019.

Lung cancer accounts for the most cancer deaths. — About 1 in 5 will die from cancer in their lifetime.

(Source: American Cancer Society, Cancer Facts & Figures for African Americans, 2019-2021)

ARTHRITIS | 179

Chronic Disease: African American Arthritis Key Findings Twenty-three percent (23%) of Lucas County African American adults were diagnosed with arthritis.

Arthritis • Twenty-three percent (23%) of Lucas County African American adults were diagnosed with some form of

arthritis, increasing to 46% of those over the age of 65.

• Of those who were diagnosed, 65% were currently receiving treatment.

The following graph shows the percentage of Lucas County African American adults who were diagnosed with arthritis. Examples of how to interpret the information include: 23% of African American adults were diagnosed with arthritis, including 25% of females and 46% of adults ages 65 and older.


Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


23% of Lucas County African American were diagnosed with arthritis.

23% 22%25% 23%

46%

39%

14%

22%18%

22%

0%

10%

20%

30%

40%

50%

60%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with Arthritis

ASTHMA | 180

Chronic Disease: African American Asthma Key Findings In 2020, 19% of Lucas County African American adults were diagnosed with asthma. Asthma and Other Respiratory Disease • In 2020, 19% of Lucas County African American adults had been diagnosed with asthma, increasing to 27% of

those with incomes of $25,000 or more.

• Sixty-nine percent (69%) of Lucas County African American adults with asthma were currently receiving treatment for the diagnosis.

• Five percent (5%) of Lucas County African American adults were diagnosed with chronic obstructive pulmonary

disorder (COPD).

• Sixty-seven percent (67%) of African American adults were diagnosed with chronic obstructive pulmonary disorder (COPD) were currently receiving treatment.

• There are several important factors that may trigger an asthma attack. Some of these triggers are tobacco

smoke; dust mites; outdoor air pollution; cockroach allergens; pets; mold; smoke from burning wood or grass; and infections linked to the flu, colds, and respiratory viruses (Source: CDC, 2017).

• Chronic lower respiratory disease was the sixth leading cause of death in Lucas County African American adults

and the sixth leading cause of death in African American Ohio adults in 2016 to 2018 (Source: Ohio Public Health Data Warehouse 2016-2018).

The following graph shows the percentage of Lucas County African American adults who were diagnosed with asthma. Examples of how to interpret the information include: 19% of African American adults were diagnosed with asthma, including 23% of females and 27% of adults with incomes of $25,000 or more.


Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Diagnosed with asthma

15% 14% 15% 14% 19% 16% 18%

19%16%

23%

15%12%

10%

27%

14% 15% 14%

0%

10%

20%

30%

40%

LucasAfrican

American2020

Males Females 30-64Years


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with Asthma

ASTHMA | 181

The following graph shows the percentage of Lucas County African American adults who were diagnosed with COPD. Examples of how to interpret the information include: 5% of African American adults were diagnosed with COPD, including 8% of adults with incomes less than $25,000 and 12% of adults ages 65 and older.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey. The following graph shows the African American Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for chronic lower respiratory diseases (formerly COPD) in comparison with the Healthy People 2020 objective. The graph shows: • From 2016 to 2018, Lucas County’s age-adjusted mortality rate for chronic lower respiratory disease was higher

than the Ohio and U.S. rates and lower than the Healthy People 2020 target objective rate.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2015-2017) *Healthy People 2020’s rate is for adults aged 45 years and older. Healthy People 2020 target is not race specific

5%6%

3%4%

12%

8%

2%

0%

5%

10%

15%

20%


Males Females 30-64 Years 65 & Over Income <$25K Income $25K Plus

Lucas County African American Adults Diagnosed with COPD

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African American Age-Adjusted Mortality Rates for Chronic Lower Respiratory Diseases (Formerly COPD)


DIABETES | 182

Chronic Disease: African American Diabetes

Key Findings In 2020, 15% of Lucas County African American adults were diagnosed with diabetes at some point in their lifetime. Thirty-eight percent (38%) of African American adults with diabetes rated their health as fair or poor.

Diabetes • Fifteen percent (15%) of Lucas County African American adults were diagnosed with diabetes at some point in

their lifetime, increasing to 29% of those over the age of 65. • One hundred percent (100%) of Lucas County African American adults diagnosed with diabetes were receiving

treatment.

• A test for A1C measures the average level of blood sugar over the past three months. Eight percent (8%) of Lucas County African American adults reported getting their A1C checked three or more times in the past year. Ten percent (10%) said two times, 26% said one time, 43% said none and 13% said they did not know if they had gotten their A1C checked within the past year.

• Thirty-eight percent (38%) of Lucas County African American adults with diabetes rated their health as fair or

poor. • Lucas County African American adults diagnosed with diabetes also had one or more of the following

characteristics or conditions: — Overweight or obese (89%) — High blood cholesterol (29%) — High blood pressure (22%)

The following graph shows the percentage of Lucas County African American adults who were diagnosed with diabetes. Examples of how to interpret the information include: 15% of African American adults were diagnosed with diabetes, including 15% of females and 29% of adults ages 65 and older.


15% of Lucas County African American adults were diagnosed with diabetes.

15% 16% 15%17%

29% 29%

10%

17%21% 22%

0%

10%

20%

30%

40%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults Diagnosed with Diabetes

DIABETES | 183

The following graphs show prevalence of diabetes by gender and the age-adjusted mortality rates from diabetes for Lucas County and Ohio residents with comparison to the Healthy People 2020 target objective. • From 2016 to 2018, Lucas County’s age-adjusted diabetes mortality rate was slightly greater than the Ohio

and the U.S. rates, but lower than the Healthy People 2020 target objective.

*The Healthy People 2020 rate is for all diabetes-related deaths. Healthy People 2020 target is not race specific (Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2016-2018, Healthy People 2020)

Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018


50

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African American Age-Adjusted Mortality Rates for Diabetes and Healthy People 2020 Objectives



Chronic Disease: African American Quality of Life

Key Findings In 2020, 45% of Lucas County African American adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were arthritis/rheumatism (48%); back or neck problems (42%); stress, depression, anxiety and emotional problems (32%); vision problems (31%); and chronic pain (25%).

Impairments and Health Problems • Forty-five percent (45%) of Lucas County African American adults were limited in some way because of a

physical, mental or emotional problem.


— Arthritis/rheumatism (48%) — Back or neck problems (42%) — Stress, depression, anxiety, or emotional

problems (32%) — Eye/vision problems (31%) — Chronic pain (25%) — Walking problems (23%) — Chronic illness (23%) — Sleep problems (23%) — Dental problems (17%) — Lung/breathing problems (11%)

— Fractures, bone/joint injuries (14%) — Substance dependency (8%) — Drug addiction (6%) — Fitness level (6%) — Memory loss (6%) — Learning disability (5%) — Mental health illness/disorder (3%) — Hearing problems (3%) — Confusion (2%) — Other impairments/problems (5%)

• In the past year, Lucas County African American adults reported needing the following services or equipment: eyeglasses or vision services (34%), pain management (12%), canes (10%), help with routine needs (9%), help with personal care needs (7%), walkers (5%), medical supplies (2%), wheelchairs (2%), wheelchair ramps (2%), personal emergency response systems (2%), mobility aids or devices (2%), special beds (2%), oxygen or respiratory support (1%), and hearing aids or hearing care (1%).

• Thirty percent (30%) of Lucas County African American adults had fallen in the past year, increasing to 28% of those 65 and older.


Adult Comparisons


Americans 2007


Americans 2011


Americans 2014


Americans 2017


Americans 2020

Ohio African

Americans 2018

U.S. African

Americans 2018

Limited in some way because of a physical, mental, or emotional problems

53% N/A 49% 56% 45% N/A N/A

45% of African American adults were limited in some way because of a physical, mental or emotional problem.


The following graphs show the percentage of Lucas County adults that were limited in some way and the most limiting health problems. Examples of how to interpret the information on the first graph include: 45% of Lucas County adults were limited in some way, including 44% of males and 49% of those ages 65 and older.


Healthy People 2020* Arthritis, Osteoporosis, and Chronic Back Conditions (AOCBC)

Objective


American 2020



48% 36%

Note: U.S. baseline is age-adjusted to the 2000 population standard. *Healthy People 2020 target is not race specific. (Sources: Healthy People 2020 Objectives, 2019/2020 Lucas County Health Assessment)

48%42%

32% 31%25%

0%

20%

40%

60%

80%

Arthritis/Rheumatism Back/Neck Problems Stress, Depression,Anxiety, or Emotional

Problems

Eye/Vision problems Chronic Pain

Lucas County African American Adults' Most Limiting Health Problems

45% 44% 44% 45%49%

57%

34%

49%

56%

0%

25%

50%

75%


2020


Income $25KPlus


2014


2017

Lucas County African American Adults Limited in Some Way


Social Conditions: African American Social Determinants of Health

Key Findings

In 2020, 19% of Lucas County African American adults had to choose between paying bills and buying food. Eighteen percent (18%) of Lucas County African American adults experienced four or more adverse childhood experiences (ACEs) in their lifetime.

Healthy People 2020



Economic Stability

• Lucas County African American adults reported the following about their housing situation: — Had housing (87%) — Had housing, but were worried about losing housing in the future (21%) — Did not have housing (1%) — Don’t know (2%)

• Lucas County African American adults attempted to get assistance from the following social service agencies: Job & Family Services/JFS (23%), food pantries (13%), Salvation Army (8%), Pathway (7%), friend or family member (6%), other charities (6%), place of worship (5%), WIC/health department (5%), United Way (4%), free clinic (2%), legal aid (2%), and somewhere else (8%). Three percent (3%) of African American adults did not know where to look for assistance, and 6% did not qualify for assistance.

• Lucas County African American adults experienced the following food insecurity issues during the past year: had to choose between paying bills and buying food (19%), worried food would run out (11%), food assistance was cut (9%), went hungry/ate less to provide more food for their family (7%), were hungry but did not eat because they did not have money for food (7%), and loss of income led to food insecurity issues (4%).

• Fourteen percent (14%) of Lucas County African American adults experienced more than one food insecurity issue in the past year.

• The median household income in Lucas County was $49,448. The U.S. Census Bureau reports median income levels of $58,642 for Ohio and $65,712 for the U.S. (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

• Thirty-six percent (36%) of all Lucas County African American residents were living in poverty (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimates).

• The unemployment rate for Lucas County was 10.6 as of July of 2020 (Source: Bureau of Labor Statistics, Local Area Unemployment Statistics).

• There were 203,795 housing units. The owner-occupied housing unit rate was 60%. Rent in Lucas County cost

an average of $757 per month (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

14% of Lucas County African American adults experienced more than one food insecurity issue in the past year.




Lucas County African American adults and their loved ones needed the following assistance in the past year:

Type of Assistance Needed Assistance

Did Not Know

Where to Look

Did Not Need

Assistance


Affordable child care 1% 5% 94%

Clothing 1% 4% 95%



Diapers 1% 2% 97%



Food 13% 2% 85%


Gambling addiction 1% 1% 98%





Medicare 17% 2% 82%





Septic/well repairs 1% 1% 98%


Unplanned pregnancy 1% 1% 98%

Utilities 7% 7% 86%


Social and Community Context • Lucas County African American adults experienced the following in the past year:

— Death of a family member or close friend (49%) — A close family member had to go to the hospital (35%) — Had bills they could not pay (24%) — Someone in their household lost their job/had their hours at work reduced (13%) — Moved to a new address (12%) — Decline in their own health (11%) — Someone close to them had a problem with drinking or drugs (8%) — Had someone homeless living with them or sleeping on their couch (8%) — Knew someone who lived in a hotel (7%) — Was homeless (5%) — Was threatened or abused by someone physically, emotionally, sexually, and/or verbally (5%) — Their family as at risk for losing their home (5%) — Due to unforeseen circumstances, their household income was cut by 50% (4%) — They were a caregiver (3%) — Witnessed someone in their family being hit or slapped (3%) — Their child was threated or abused by someone physically, emotionally, sexually, and/or verbally (2%) — Became separated or divorced (1%)

• Forty-four percent (44%) of Lucas County African American adults reported gambling in the past year. They reported the following types of gambling: lottery/scratch-offs/office pools (73%); casino gambling (36%); poker or other card games, dice, or craps (not at a casino) (8%); sports betting with a bookie/office pools (7%); and bingo (7%).

• Lucas County African American adults reported engaging in some form of gambling:


• Lucas County African American adults experienced the following due to gambling: unable to pay bills (2%), felt the need to lie to hide the extent of their gambling (2%), consumed more alcohol or drugs when gambling (1%), tried to cut down or stop gambling (1%), gambled with larger amounts of money to get the same excitement (1%), someone expressed a concern about their gambling (1%), and lied to family members or others to hide their gambling (1%).

. • Fourteen percent (14%) of Lucas County African American adults were threatened with abuse in the past year

by the following individuals: a spouse or partner (32%) and someone else (63%).

• Ten percent (10%) of Lucas County African American adults were abused (including physical, sexual, emotional, financial and verbal) in the past year by the following individuals: a spouse or partner (85%), a parent (8%), another person from outside the home (8%), and someone else (14%).


• Adverse childhood experiences (ACEs) are stressful or traumatic events, including abuse and neglect. They also include household dysfunction such as witnessed domestic violence or growing up with family members who have substance use disorders. ACEs are strongly related to the development of depression, alcoholism and alcohol abuse; depression; illicit drug use; chronic obstructive pulmonary disease; suicide attempts; and many other health problems throughout a person’s lifespan (SAMHA, Adverse Childhood Experiences, Updated on 7/2/2020).

• Lucas County African American adults experienced the following adverse childhood experiences (ACEs): — Their parents became separated or were divorced (29%) — Lived with someone who was a problem drinker or alcoholic (16%) — Lived with someone who was depressed, mentally ill, or suicidal (16%) — Their parents were not married (16%) — Their parents or adults in their home slapped, hit, kicked, punched, or beat each other up (15%) — Someone at least five years older than them or an adult touched them sexually (14%) — Lived with someone who used illegal stress drugs, or who abused prescription medications (14%) — A parent or adult in their home swore at them, insulted them, or put them down (13%) — Lived with someone who served time or was sentenced to serve time in prison, jail or correctional facility (12%) — Their family did not look out for each other, feel close to each other, or support each other (11%) — Someone at least five years older than them or an adult tried to make them touch them sexually (10%) — They didn’t have enough to eat, had to wear dirty clothing, and had no one to protect them (5%) — A parent or adult in their home hit, beat, kicked, or physically hurt them (5%) — Someone at least five years older than them or an adult forced them to have sex (2%)

• Eighteen percent (17%) of Lucas County African American adults experienced four or more adverse childhood

experiences (ACEs). The following graph shows the percentage of Lucas County African American adults who experienced four or more adverse child experiences (ACEs) in their lifetime. Examples of how to interpret the information on the graph include: 18% of all Lucas County African American adults had experienced four or more ACEs in their lifetime, including 20% of males and 17% of those with annual incomes less than $25,000.


survey.

18%20%

15%16%

4%

17%

14%

0%

10%

20%

30%



Lucas County African American Adults Who Experienced Four or More ACEs


The table below indicates correlations between African American adults who experienced four or more ACEs in their lifetime and participating in risky behaviors, as well as other experiences. An example of how to interpret the information includes: 36% of African American adults who experienced four or more ACEs had contemplated suicide in the past year, compared to 5% of those who did not experience any ACEs.


African American Adult Behaviors Experienced four or more

ACEs






29% 59%


22% 4%

Had two or more sexual partners (in the past year) 18% 2% *“ACEs indicate adults who self-reported having experienced four or more adverse childhood experiences in their lifetime. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey. Veterans Affairs

• As a result of military service during the past 10-15 years, the following have affected African American veterans’ immediate family members: access to medical care at a Veterans Affairs facility (16%), post-traumatic stress disorder (PTSD) (13%), had problems getting Veterans Affairs benefits (13%), had problems getting information on Veterans Affairs eligibility and applying (13%), major health problems due to injury (7%), housing issues (6%), incarceration/re-entry (6%), access to mental health treatment (6%), could not find/keep a job (6%), marital problems (4%), suicide completion (4%), access to medical care at a non-Veterans Affairs facility (4%), and substance/drug abuse/overdose (3%).

Reactions to Race

• At work within the past year, 21% of Lucas County African American adults felt they were treated worse than people of other races. Forty percent (40%) felt they were treated the same at work, and 1% reported they were treated better than other races at work.

• Within the past year, when seeking health care, 10% of Lucas County African American adults felt their

experiences in the past year were worse than people of other races. Fifty-one percent (51%) felt their experiences were the same, and no adult reported their experiences were better than people of other races when seeking health care.

• More than one-third (33%) of Lucas County African American adults reported feeling emotional distress (such as anger, sad, frustration) or was physical distress (such as experiencing a stomachache, headache, anxiety) as a result of how they were treated based on their race, ethnicity, sex, age, language, culture, religion, nationality, or sexual orientation in the past month.

• During the past month, 27% of Lucas County African American adults experienced physical symptoms (for

example, a headache, an upset stomach, tensing of muscles, or a pounding heart) as a result of how they were treated based on their race, increasing to 35% of those with annual incomes of $25,000 or more.


• During the past month, Lucas County African American adults felt emotionally upset as a result of how they were treated because of their: — Skin color (24%) — Ethnicity (21%) — Religion (9%) — Culture (8%) — Sexual orientation (5%) — Disability (4%) — Gender identity (1%)

Lucas County African American Adults Experiences When Seeking Health Care*

Demographics

Experiences When Seeking Health Care Worse than People of

Other Races

Better than People of

Other Races

Same as People of

Other Races

Don’t Know

Total (African American) 9% 0% 47% 33%

White 1% 10% 53% 34% Latino of any race 2% 7% 57% 22%

*Percentages may not equal 100% due to the exclusion of data for those who did not have health care and answered multiple responses. Neighborhood and Built Environment

• Thirteen percent (13%) of Lucas County African American adults reported that their neighborhood was extremely safe, 51% reported it to be quite safe, 23% reported it to be slightly safe, and 7% reported it to be not safe at all. Seven percent (7%) reported that they did not know how safe from crime their neighborhood was.

The following graph shows the percentage of Lucas County African American adults who described their neighborhood as extremely safe, quite safe and slightly/not safe. Examples of how to interpret the information include: 13% of all Lucas County African American adults described their neighborhood as extremely safe, including 8% of those with annual incomes less than $25,000.

*Respondents were asked: “How safe from crime do you consider your neighborhood to be?”

Note: percentages may not equal 100% due to those who responded “don’t know” Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey.

13%6%

17% 11% 13% 8%20%

1%8% 4%

51%

47%

52%

45%51%

50%

51%

28%

33%33%

8%39%

25%35%

8% 35%

26%

66% 51% 54%

0%

20%

40%

60%

80%

100%


2020

Males Females 30-64 years 65 & Over Income <$25K Income$25KPlus


2011


2014


2017

Lucas County African American Adult Neighborhood Safety Perceptions*



• Seventy percent (70%) of Lucas County African American adults reported deliberately testing all of the smoke detectors in their home within the past year. Nine percent (9%) have never tested the smoke detectors in their home.

• More than one-fourth (28%) of Lucas County African American adults reported the following transportation

issues: no car (20%), no driver’s license/suspended license (11%), no car insurance (5%), cost of public or private transportation (5%), limited public transportation available or accessible (5%), other car issues/expenses (4%), disabled (2%), no public transportation available or accessible (1%), and cannot afford gas (1%). Eighteen percent (18%) of adults who reported having transportation issues had more than one issue.

• Lucas County African American adults indicated they use the following forms of transportation regularly: vehicle or family vehicle (86%), ride from a friend or family member (22%), walk (11%), public transportation (8%), bike (3%), and other (8%).

• Lucas County African American adults reported doing the following while driving: eating (32%); talking on hand-held cell phone (37%); texting (21%); using cell phone other than for talking or texting (17%); using Internet/apps/social media on their cell phone (15%); driving without wearing a seatbelt (11%); being under the influence of prescription drugs (5%); being under the influence of recreational drugs (4%); reading (2%); being under the influence of alcohol (2%); and other activities (such as applying makeup, shaving, etc.) (2%). Of adult drivers, 34% had more than one distraction. Fifteen percent (15%) of adults reported they did not drive.

• More than half (22%) of Lucas County African American adults kept a firearm in or around their home. Three

percent (3%) of adults reported that their firearms were unlocked and loaded.

• Lucas County African American adults with firearms in or around their home reported the following reasons for having them: protection (79%), hunting or sport (3%), and other reasons (6%).

The following graph shows the percentage of Lucas County African American adults that had a firearm in or around the home. Examples of how to interpret the information include: 22% of all Lucas County African American adults had a firearm in or around the home, including 30% of males and 30% of those with annual incomes of $25,000 or more.


survey.

22%

30%

18%

24% 23%

9%

30%

23%20%

29%

0%

10%

20%

30%

40%

LucasAfrican

American2020


Income$25K Plus

LucasAfrican

American2011

LucasAfrican

American2014

LucasAfrican

American2017

Lucas County African American Adults With a Firearm in the Home

ENVIRONMENTAL HEALTH | 193

Social Conditions: Environmental Conditions Key Findings Lucas County African American adults reported the following as the top four issues that threatened their health in the past year: mold (8%), bed bugs (8%), insects (7%), and rodents (6%). Eight percent (8%) of African American adults reported they had a disaster plan in preparation of a disaster. Environmental Health • Lucas County African American adults thought the following threatened their or their family members’ health in

the past year: — Mold (8%) — Bed bugs (8%) — Insects (7%) — Rodents (6%) — Plumbing problems (5%) — Safety hazards (structural problems) (5%) — Air quality (4%) — Temperature regulation (heating and air

conditioning) (3%)

— Moisture issues (2%) — Cockroaches (2%) — Sewage/wastewater problems (2%) — Unsafe water supply/wells (2%) — Lice (1%) — Chemicals found in household products

(1%) — Radon (1%)

• Fifteen percent (15%) of Lucas County African American adults reported more than one environmental issue

that threatened their or their family members’ health in the past year. Disaster Preparedness • Lucas County African American households had the following disaster preparedness supplies: cell phone

(76%), working smoke detector (59%), working flashlight and working batteries (53%), computer/tablet (50%), three-day supply of nonperishable food for everyone in the household (46%), working battery-operated radio and working batteries (46%), three-day supply of prescription medication for each person who takes prescribed medicines (40%), three-day supply of water for everyone in the household (one gallon of water per person per day) (38%), home land-line telephone (31%), working carbon monoxide detector (29%), communication plan (25%), generator (9%), and disaster plan (8%).

• Seventy-eight percent (78%) of Lucas County African American adults reported having more than one

disaster preparedness supply. Seventeen percent (17%) of adults reported having none of the above disaster preparedness supplies.

8% of African American adults reported that mold threatened their or their family members’ health in the past year.


Health Care Access: Latino Health Care Coverage Key Findings Ten percent (10%) of Lucas County Latino adults were without health care coverage in 2020. Those most likely to be uninsured were females (15%) and those with an annual income level of $25,000 or more (11%).

Health Care Coverage • In 2020, 90% of Lucas County Latino adults had health care coverage, and 10% who were uninsured. • Sixteen percent (16%) of Lucas County Latino adults with children did not have health care coverage, compared

to 4% of those who did not have children living in their household.

• The top reasons uninsured Latino adults gave for being without health care coverage were: 1. They lost their job or changed employers (38%) 2. Became ineligible (20%) 3. Did not think they needed it (18%) 4. Cost (15%)


• The following types of health care coverage were used: employer (61%); Medicaid or medical assistance (15%); Medicare (11%); someone else’s employer (8%); multiple, including private insurance (3%); Health Insurance Marketplace (2%); multiple, including government insurance (1%); and military, CHAMPUS, TriCare, CHAMPVA or the VA (1%).

• Lucas County Latino adults had the following issues regarding their health care coverage: — Cost (44%) — Opted out of certain coverage because they could not afford it (17%) — Could not understand their insurance plan (11%) — Limited visits (10%) — Provider was no longer covered (8%) — Service not deemed medically necessary (7%) — Working with their insurance company (6%) — Opted out of certain coverage because they did not need it (5%) — Service no longer covered (4%) — Pre-existing conditions (2%)

Adult Comparisons


2007


2011


2014

Lucas County Latinos 2017


2020

Ohio Latinos

2018

U.S. Latinos 2018

Uninsured 13% 17% 19% 10% 10% 18% 28%

In Lucas County, 10% of Latino adults were uninsured.


The following graph shows the percentage of Lucas County Latino adults who were uninsured. Examples of how to interpret the information include: 10% of all Lucas County Latino adults were uninsured, including 9% of Latino adults with annual incomes less than $25,000 and 15% of females. The pie chart shows sources of Lucas County Latino adults’ health care coverage.


Employer, 61%

Medicare, 11%

Medicaid, 15%


Military, 1%


Multiple, including private

insurance, 3%

Multiple, including

government insurance, 1%

Source of Health Coverage for Lucas County Latino Adults

10%

6%

15%

10%

3%

9%11%

17%19%

10%

0%

10%

20%

30%

Lucas Latino2020


Income$25Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Who Were Uninsured


The following chart shows what is included in Lucas County Latino adults’ insurance coverage.


Medical 97% 0% 3%


Dental 87% 12% 1%




84% 3% 13%


76% 3% 21%



Hospice 44% 7% 49%




33% 9% 58%


Healthy People 2020

Access to Health Services (AHS)

Note: U.S. baseline is age-adjusted to the 2000 population standard. (Sources: Healthy People 2020 Objectives, 2018 BRFSS, 22019/2020 Lucas County Health Assessment) *Ohio/ U.S. percentages and Healthy People target are not race specific. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.


Latinos 2020

Ohio 2018*

U.S. 2018*

Healthy People 2020

Target

AHS-1.1: Persons under age of 65 years with health insurance




100%


Health Care Access: Latino Access and Utilization

Key Findings Ten percent (10%) of Lucas County Latino adults went outside of Lucas County for health care services in the past year. Twenty-one percent (21%) of Lucas County Latino adults looked for a program to help with depression, anxiety, or some mental health problem.

Health Care Access and Utilization • Lucas County Latino adults usually visited the following places for health care services when they were sick or

needed advice: — Doctor’s office (86%) — Urgent care center (38%) — Hospital emergency room (19%) — Family and friends (17%) — Internet (13%) — Chiropractor (12%) — Alternative therapies (6%) — In-store health clinic (4%) — Community health center (4%) — Veteran’s Affairs (VA) (2%) — Called 9-1-1/used an ambulance service (2%) — Telemedicine (2%) — Some other place (1%) — Three percent (3%) of Latino adults indicated they had no usual place for health care services.

• The following prevented Lucas County Latino adults from getting medical care in the past year: cost/no

insurance (66%), no need to go (12%), office was not open when they could get there (2%), too long of a wait for an appointment (1%), their provider did not take their insurance (1%), too embarrassed to seek help (1%), concerned they would be treated differently (1%), and other reasons (2%).

During the past year, 66% of Latino adults did not receive medical care due to cost/no insurance.

Health and Health Care for Hispanics in the United States

Hispanics face greater barriers to accessing care and receive less care than whites. For example: • One in four (25%) of Hispanic adults ages 18-64 are uninsured, compared to 8% of white adults in the

same age range • More than one in five (22%) of Hispanic adults went without care due to cost, compared to 13% of white

adults. • One in four (25%) of Hispanic adults report no usual source of care, compared to 14% of white adults. • Twenty-five percent (25%) of Hispanic adults report no health care visit in the past year, compared to

15% of white adults. • Forty-six percent (46%) of Hispanic adults did not visit a dentist in the past year, compared to 32% of

white adults.

Although uninsured rates for Hispanics declined under the Affordable Care Act, Hispanics are still more likely to be uninsured than whites.

• From 2013-2017, the uninsured rate among non-elderly Hispanic adults decreased from 40% to 25%, a 15% decrease. During the same time period, uninsured rates decreased from 15% to 8% for non-elderly white adults.

• From 2013-2017, the uninsured rate among Hispanic children decreased from 12% to 8%, a 4% decrease. During the same time period, uninsured rates decreased from 6% to 4% for white children.

(Source: Kaiser Family Foundation, Health and Health Care for Hispanics in the U.S., Updated, May 10, 2019)


• Ten percent (10%) of Lucas County Latino adults went outside of Lucas County for health care services in the past year. Those who went outside of Lucas County for health services gave the following reasons: the wait list was too long in Lucas County (38%), there was a better quality program (23%), service was not available locally (15%), had insurance restrictions (15%), did not like local services/provider (8%), went there because they used to live there (8%), word of mouth (8%), and other (8%).

• More than one-third (34%) of Lucas County Latino adults did not get their prescriptions from their doctor

filled in the past year.

• Lucas County Latino adults reported the following reasons for not getting their prescriptions filled in the past year: too expensive (42%), did not think they needed it (26%), no generic equivalent of what was prescribed (23%), stretched current prescription by taking less than what was prescribed (21%), side effects (16%), did not have any prescriptions to be filled (14%), no insurance (9%), they were already taking too many medications (9%), transportation (5%), and fear of addiction (2%).


to make decisions for themselves. Sixteen percent (16%) of Lucas County Latino adults reported they had a living will, increasing to 20% of those with annual incomes more than $25,000 and increasing to 48% of those over the age of 65.

• A durable power of attorney is a written legal document in which people name an individual who will make medical decisions for them when they are unable to do so. Nine percent (9%) of Lucas County Latino adults had a durable power of attorney, increasing to 32% of those over the age of 65.

• Of the Lucas County Latino adults who did not have a living will or durable power of attorney, 34% had

discussed their medical wishes with a family member or loved one.

Hispanic/Latino Insurance Coverage

It is significant to note that Hispanics have the highest uninsured rates of any racial or ethnic group within the United States.

• In 2017, the Census Bureau reported that 49.0 percent of Hispanics had private insurance coverage, as compared to 75.4 percent for non-Hispanic whites. Among Hispanic subgroups, coverage varied as follows: 46.7 percent of Mexicans, 54.6 percent of Puerto Ricans, 55.9 percent of Cubans, 41.9 percent of Central Americans.

• In 2017, 38.2 percent of all Hispanics had public health insurance coverage, as compared to 33.7 percent

for non-Hispanic whites. Public health insurance coverage varied among Hispanic subgroups: 38.4 percent of Mexicans, 45.1 percent of Puerto Ricans, 35.6 of Cubans, and 34.4 percent of Central Americans.

• Those without health insurance coverage varied among Hispanic subgroups: 19.3 percent of Mexicans,

7.9 percent of Puerto Ricans, 13.7 percent of Cubans and 27.2 percent of Central Americans. In 2017, 17.8 percent of the Hispanic population was not covered by health insurance, as compared to 5.9 percent of the non-Hispanic white population.

(Source: U.S. Department of Health and Human Services Office of Minority Health, Profile: Hispanic/Latino Americans, Updated, August 22, 2019)


Availability of Services

Lucas County Latino Adults Able to Access Assistance Programs/Services


Types of Programs (% of all Latino adults who looked for the programs)

Lucas County Latino adults who have looked but have NOT found a specific program

Lucas County Latino adults who have looked and have found a specific program


33% 67%


100% 0%


78% 22%


78% 22%


75% 25%


57% 43%


67% 33%


80% 20%


80% 20%


0% 100%


0% 100%


67% 33%


0% 100%


50% 50%


0% 100%


0% 100%


100% 0%


0% 100%


Health Care Access: Latino Preventive Medicine Key Findings Sixty-five percent (65%) of Lucas County Latino adults had a flu vaccine during the past year. Seventy percent (70%) of Latino adults ages 65 and older had a pneumonia vaccine at some time in their life.

Preventive Medicine

• Sixty-five percent (65%) of Lucas County Latino adults had a flu vaccine during the past year, increasing to 87% of those 65 and older.

• More than one-quarter (31%) of Lucas County Latino adults have had a pneumonia vaccine in their life, increasing to 70% of those ages 65 and over.

• Lucas County Latino adults have had the following vaccines: — Measles, mumps, and rubella (MMR) in their lifetime (77%) — Chicken pox vaccine in their lifetime (68%) — Tetanus booster (Td/Tdap) in the past ten years (64%) — Hepatitis B vaccine in their lifetime (53%) — Hepatitis A vaccine in their lifetime (51%) — Influenza type B vaccine in their lifetime (49%) — Meningococcal vaccine in their lifetime (26%) — Human papillomavirus (HPV) vaccine in their lifetime (22%) — Zoster (shingles) vaccine in their lifetime (16%)


• In the past year, 69% of Lucas County Latina women ages 40 and older had a mammogram.

• In the past year, 19% of Latino men ages 50 and older had a digital rectal exam.

• See the Women’s and Men’s Health Sections for further prostate, mammogram, clinical breast exam, and Pap smear screening test information for Lucas County Latino adults.

Lucas County Latino Adult Health Screening Results






Survived a Stroke 5% *Percentages based on all Lucas County Latino adults surveyed.


Health Care Topics Discussed by Lucas County Latino Adults With Their Health Care Professional in the Past Year


Total 2020

Alcohol use 14% 14%

Child care N/A 1%

Depression, anxiety, or emotional problems 23% 34%

Domestic violence 9% 7%

Drug abuse 7% 10%

E-cigarettes/vaping N/A 9%

Education N/A 10%

Family history N/A 34%

Family planning 5% 5%

Financial strains N/A 5%

Food access N/A 9%

Housing N/A 6%

Immunizations 21% 32%

Injury prevention (e.g., safety belt use, helmet use & smoke detectors)

10% 7%


10% 4%

Safe use of prescription medication 16% 13%

Sexually transmitted diseases (STDs) 10% 10%

Social connections N/A 7%

Tobacco use 9% 11%

Training and employment N/A 8%

Transportation N/A 1%

Utilities N/A 1%

Weight control (e.g., diet, physical activity) 31% 37% N/A – Not Available

Adult Comparisons



2011


2014



2020

Ohio Latinos

2018

U.S. Latinos

2018


53% 52% 67% 70% 70% N/A 56%

Had a flu vaccine in the past year

31% 37% 52% 40% 65% 33% 25%


75% 64% 82% 84% 87% N/A 50%

Ever had a shingles or zoster vaccine

N/A N/A 7% 7% 16% N/A N/A



The following graph shows the percentage of Lucas County Latino adults who received a flu vaccine within the past year. Examples of how to interpret the information shown on the graph include: 65% of Lucas County Latino adults received a flu vaccine within the past year, including 66% of Latino males and 69% of those with annual incomes less than $25,000.


Healthy People 2020*

Immunization and Infectious Diseases (IID)

Note: U.S. baseline is age-adjusted to the 2000 population standard. *Healthy People 2020 Target is not race specific. (Sources: Healthy People 2020 Objectives, 2018 BRFSS, 2020 Lucas County Health Assessment)

Objective


2020

Healthy People 2020

Target


70% 90%


87% 90%


16% 30%

65% 66%62% 61%

87%

69%65%

37%

52%

40%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults who Received a Flu Shot Within the Past Year


Health Care Access: Latina Women’s Health Key Findings In 2020, 69% of Lucas County Latina women ages 40 and older reported having a mammogram. In the past year, 60% of Lucas County Latina women had a clinical breast exam, and 54% had a Pap smear to detect cancer of the cervix. More than half (56%) were obese, 27% had high blood pressure,18% had high blood cholesterol, and 14% were identified as current smokers, which are all known risk factors for cardiovascular diseases.


• Seventy-three percent (73%) of Lucas County Latina women had a mammogram at some time in their life, and more than half (53%) had this screening in the past year.

• Sixty-nine percent (69%) of Lucas County Latina women ages 40 and older had a mammogram in the past year, and 94% had one in the past two years.

• All (100%) Lucas County Latina women had a clinical breast exam at some time in their life, and 60% had one within the past year. Eighty-seven percent (87%) of Latina women ages 40 and older had a clinical breast exam in the past two years.

• One hundred percent (100%) of Lucas County Latina women had a Pap smear at some time in their life, and 54% reported having had the exam in the past year. Eighty-seven percent (87%) of Latina women had a Pap smear in the past three years.

Pregnancy • One-third (33%) of Lucas County Latina women had been pregnant in the past five years. • Thinking back to their last pregnancy, 50% of Lucas County Latina women wanted to be pregnant then, 28% of

Latina women did not recall,11% wanted to be pregnant sooner, and 11% did not want to be pregnant then or any time in the future.


• Lucas County Latina women used the following as their usual source of services for female health concerns: private gynecologist (65%), general or family physician (17%), family planning clinic (6%), and community health center (2%). Four percent (4%) of Latina women indicated they did not have a usual source of services for female health concerns.


pressure, physical inactivity, and diabetes. In 2020, the community health assessment identified that: 74% of Lucas County Latina women were overweight or obese — 27% of Lucas County Latina women were diagnosed with high blood pressure — 18% of Lucas County Latina women were diagnosed with high blood cholesterol — 14% of Lucas County Latina women all Latina women were current smokers — 13% of Lucas County Latina women had been diagnosed with diabetes

Lucas County Latina Female Leading Causes of Death, 2016 – 2018 Total Lucas County Latina Female Deaths:

139

1. Cancers (20% of all deaths) 2. Heart Diseases (19%) 3. Accidents, Unintentional Injuries (12%) 4. Diabetes (6%) 5. Stroke (6%)

(Source: Ohio Public Warehouse, 2016-2018)

Ohio Latina Female Leading Causes of Death, 2016 – 2018 Total Ohio Latina Female Deaths: 1,445

1. Cancers (20% of all deaths) 2. Heart Diseases (17%) 3. Accidents, Unintentional Injuries (10%) 4. Stroke (5%) 5. Alzheimer’s disease (4%)



The following graph shows the percentage of Lucas County Latina female adults that had various health exams in the past year. Examples of how to interpret the information include: 53% of Lucas County Latina females had a mammogram within the past year, 60% had a clinical breast exam, and 54% had a Pap smear.


Adult Comparisons






Ohio Latinos 2018

U.S. Latinos 2018


N/A N/A 61%* 69%* 89% 61% 80%

Had a mammogram in the past two years (age 40 & over)

67% 74% 80% 64% 94% 72% 72%

Had a clinical breast exam in the past two years (age 40 and over)

77% 64% 70% 69% 87% N/A N/A

N/A – Not Available *Includes all women regardless of age.

53%

33%

69%

50% 53%

27% 27%

60%67% 67% 67%

60%

4%

54%54%

67%

44% 43%

53%61%

48%

0%

25%

50%

75%

100%

Lucas Latino2020

Under 40 40 & Older Income <$25K Income >$25K Lucas Latino2014

Lucas Latino2017

Lucas County Latina Women's Health Exams Within the Past Year


Cancer and Hispanic Women

Hispanic American men and women generally have lower cancer rates than the non-Hispanic white population. However, disparities still exist in certain types of cancer.

• Hispanic women are 40% more likely to be diagnosed with cervical cancer, and 20% more likely to die from cervical cancer, as compared to non-Hispanic white women.

• Hispanic women are 2.2 times more likely to be diagnosed with stomach cancer, and 2.4 times more likely to die from stomach cancer, as compared to non-Hispanic white women.

• Hispanic women are 30% less likely to be diagnosed with breast cancer than non-Hispanic white women.

(Source: U.S. Department of Health and Human Services Office of Minority Health., Cancer and Hispanic Americans, Updated February 28, 2020)


Health Care Access: Latino Men’s Health

Key Findings Forty-two percent (42%) of Lucas County Latino men had a digital rectal exam in their lifetime, and 5% had one in the past year. More than one-third (35%) of Latino men had been diagnosed with high blood pressure, 23% had high blood cholesterol, and 15% were identified as smokers, which, along with obesity (48%), which are all known risk factors for cardiovascular diseases.


• Forty-two percent (42%) of Lucas County Latino men had a digital rectal exam in their lifetime, and 5% had one in the past year.



smoking, obesity, high blood cholesterol, high blood pressure, physical inactivity, and diabetes. In 2020, the health assessment identified that: — 86% of Lucas County Latino men were overweight or

obese 35% of Lucas County Latino men were diagnosed with

high blood pressure 23% of Lucas County Latino men were diagnosed with high blood cholesterol — 15% of Lucas County Latino men had been diagnosed with diabetes — 15% of Lucas County Latino men were current smokers

Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018


21% 17% 15% 14% 5% N/A N/A


Lucas County Latino Male Leading Causes of Death, 2016 – 2018 Total Lucas County Latino Male Deaths:

189

1. Heart Diseases (23% of all deaths) 2. Cancers (14%) 3. Accidents, Unintentional Injuries (14%) 4. Chronic Liver Disease and Cirrhosis (6%) 5. Stroke (5%) (Source: Ohio Public Warehouse, 2016-2018)

Ohio Latino Male Leading Causes of Death, 2016 – 2018

Total Ohio Latino Male Deaths: 1,973

1. Heart Diseases (18% of all deaths) 2. Accidents, Unintentional Injuries (17%) 3. Cancers (16%) 4. Stroke (4%) 5. Diabetes (4%)


Chronic Liver Disease and Hispanic Americans

Among the Hispanic/Latino population, chronic liver disease is a leading cause of death. While the cause is not always known, some cases can be initiated by conditions such as chronic alcoholism, obesity, and exposure to hepatitis B and C viruses.

• In 2018, chronic liver disease was the seventh leading cause of death for all Hispanics, and the fourth leading cause of death for Hispanic men, ages 55-64.

• Both Hispanic men and women have a chronic liver disease rate that is twice that of the non-Hispanic white population.

• Hispanic men and women are 1.6 and 1.8 times more likely to die respectively from liver and IBD (inflammatory bowel disease) cancer than their non-Hispanic white counterparts.

(Source: U.S. Department of Health and Human Services Office of Minority Health., Updated, March 13, 2020)


The following graphs show the percentage of Lucas County Latino males that had digital rectal exams in the past year. Examples of how to interpret the information include: 5% of Lucas County Latino males had a digital rectal exam within the past year, including 19% of those ages 50 and older and 5% of those with annual incomes more than $25,000.


5%

0%

19%

0%

5%

17%15% 14%

0%

10%

20%

30%

Lucas Latino2020

Under 50 50 & Older Income<25K

Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Men's Digital Rectal Exams Within the Past Year

ORAL HEALTH | 207

Health Care Access: Oral Health Key Findings Fifty-eight percent (58%) of Lucas County Latino adults visited a dentist or dental clinic in the past year. Seventeen percent (17%) of Latino adults did not see a dentist in the past year due to cost.

Oral Health • In the past year, 58% of Lucas County Latino adults had visited a dentist or dental clinic, decreasing to 49% of

those with annual incomes less than $25,000.

• More than half (59%) of Lucas County Latino adults with dental insurance had been to the dentist in the past year, compared to 42% of those without dental insurance.

• When asked the main reason for not visiting a dentist in the last year, 33% had no reason to go/had not thought of it; 17% said cost; 17% said fear, apprehension, nervousness, pain, and dislike going; 6% had dentures; 6% did not have/know a dentist; 6% could not get into a dentist; 4% said transportation; and 10% said other reasons. Two percent (2%) of Latino adults selected multiple reasons for not visiting a dentist in the past year.

• Lucas County Latino adults completed the following oral health habits daily: brushed their teeth (94%), used

mouth wash (70%), and flossed their teeth (47%).

• Lucas County Latino adults had the following oral health issues: loose teeth (4%), no teeth (4%), skipped meals due to pain (4%), difficulty eating/chewing (3%), oral bleeding (3%), problems with dentures (2%), and missed work due to mouth pain (2%).

Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018

Visited a dentist in the past year 68% 56% 61% 39% 58% 65% 59%

Latino Adult Oral Health Within

the Past Year

Within the Past

Two Years

Within the Past

Five Years

Five or More years

Never


Males 57% 7% 14% 20% 0%

Females 60% 17% 19% 2% 0%

Total 58% 11% 16% 13% 0%

During the past year, 58% of Lucas County Latino adults visited a dentist or dental clinic.

ORAL HEALTH | 208

The following graph provides information about the frequency of Lucas County Latino adult dental visits. Examples of how to interpret the information include: 58% of Lucas County Latino adults had been to the dentist or dental clinic in the past year, including 60% of Latina females and 49% of those with annual incomes less than $25,000.


58% 57% 60% 62%57%

49%

65%

56%61%

39%

0%

20%

40%

60%

80%

100%

LucasLatino 2020


Income$25K Plus

LucasLatino 2011

LucasLatino 2014

LucasLatino 2017

Lucas County Latino Adults Visiting a Dentist or Dental Clinic in the Past Year


Health Behaviors: Latino Health Status Perceptions Key Findings In 2020, 45% of Lucas County Latino adults rated their health status as excellent or very good. Conversely,15% of Latino adults described their health as fair or poor, increasing to 27% of those with annual incomes less than $25,000. General Health Status • Nearly half (45%) of Lucas County Latino adults rated their health as excellent or very good. Lucas County

adults with higher incomes (51%) were most likely to rate their health as excellent or very good, compared to 41% of those with annual incomes less than $25,000.

• Fifteen percent (15%) of Lucas County Latino adults rated their health as fair or poor. • Lucas County Latino adults were most likely to rate their health as fair or poor if they:

— Had been diagnosed with diabetes (41%) — Had an annual household income under $25,000 (27%) — Had high blood pressure (24%) or high blood cholesterol (19%)

The following graph shows the percentage of Lucas County Latino adults who described their personal health status as excellent/very good, good, and fair/poor. Examples of how to interpret the information include: 45% of Lucas County Latino adults, 52% of males, and 43% of those ages 65 and older rated their health as excellent or very good.


15% of Lucas County Latino adults rated their general health as fair or poor.

45%52%

33%45% 43% 41%

51%38% 39%

29%

40%34%

51%35% 44%

32%

39%

42% 44%

46%

15% 14% 16% 20%13%

27%

10%20% 17%

25%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income $25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Health Perceptions*




• More than one-fifth (23%) of Lucas County Latino adults rated their physical health as not good on four or more days in the previous month.

• Lucas County Latino adults reported their physical health as not good on an average of 3.5 days in the previous

month. • Lucas County Latino adults were most likely to rate their physical health as not good (on four or more days

during the past month) if they: — Had an annual household income under $25,000 (43%) — Were 65 years of age or older (26%) — Were female (22%)

Mental Health Status

• One-third (33%) of Lucas County Latino adults rated their mental health as not good on four or more days in the previous month.

• Lucas County Latino adults reported their mental health as not good on an average of 4.9 days in the previous

month.

• Twenty-seven percent (27%) of Lucas County Latino adults reported that poor mental or physical health kept them from doing usual activities such as self-care, work, or recreation.

• Lucas County Latino adults were most likely to rate their mental health as not good (on four or more days

during the past month) if they: — Were female (49%) — Had an annual household income under $25,000 (39%) — Were ages 30-64 (36%)

The table shows the percentage of Latino adults with poor physical and mental health in the past 30 days.


Latino Health Status No Days 1-3 Days 4-5 Days 6-7 Days 8 or More Days

Physical Health Not Good in Past Month* Males 45% 22% 8% 7% 8%

Females 39% 24% 4% 0% 19% Total 42% 23% 6% 4% 13%

Mental Health Not Good in Past Month* Males 51% 18% 13% 7% 4%

Females 35% 12% 10% 0% 39% Total 45% 16% 11% 4% 18%


N/A – Not Available *County Health Rankings

Adult Comparisons






Ohio Latinos 2018

U.S. Latinos 2018

Rated health as excellent or very good

55% 38% 39% 29% 45% 57% 38%

Rated health as fair or poor 15% 20% 17% 25% 15% 12% 26% Rated their mental health as not good on four or more days in the previous month

23% 33% 38% 34% 33% N/A 23%

Average number of days that mental health was not good (in the past month)

N/A N/A N/A 6.5 4.9 N/A N/A


19% 32% 20% 34% 23% 8% 23%

Average number of days that physical health not good (in the past month)

N/A N/A N/A 7.5 3.5 N/A N/A


N/A N/A N/A 41% 27% 33% 23%

WEIGHT STATUS | 212

Health Behaviors: Latino Adult Weight Status

Key Findings Eighty percent (80%) of Lucas County Latino adults were overweight or obese based on body mass index (BMI). Twenty-nine percent (29%) of Lucas County Latino adults did not participate in any physical activity in the past week, including 1% who were unable to exercise.

Adult Weight Status

• Eighty percent (80%) of Lucas County Latino adults were either overweight (29%) or obese (51%) by body mass index (BMI), putting them at elevated risk for developing a variety of diseases.

• More than half (55%) of Lucas County Latino adults were trying to lose weight, 23% were trying to maintain their current weight or keep from gaining weight, and 4% were trying to gain weight.

• Lucas County Latino adults did the following to lose weight or keep from gaining weight in the past month: exercised (39%); drank more water (39%); ate less food, fewer calories, or foods low in fat (39%); ate a low-carb diet (19%); smoked cigarettes (3%); used a weight loss program (2%); went without eating 24 or more hours (2%); participated in a prescribed dietary or fitness program (1%); took diet pills, powders or liquids without a doctor’s advice (1%); received health coaching (1%); took prescribed medications (1%); other (5%).

• Lucas County Latino adults spent an average of 2.6 hours watching TV, 2.1 hours on their cell phone, 1.5 hours

on their PC/tablet, and 0.4 hours playing video games on an average day of the week. The following graph shows the percentage of Lucas County Latino adults who are overweight or obese by body mass index (BMI). Examples of how to interpret the information include: 17% of all Lucas County Latino adults were classified as normal weight, 29% were overweight, and 51% were obese.


51% of Lucas County Latino adults were obese.

17%9%

26%13% 20% 18% 19% 21% 21% 20%

29% 38%19%

29%

52%

21%31%

37% 30% 38%

51% 48% 56% 57%

28%

62% 47%42% 49% 42%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult BMI Classifications*


WEIGHT STATUS | 213

Physical Activity

• In Lucas County, 58% of Latino adults engaged in some type of physical activity or exercise for at least 30 minutes 3 or more days per week. Thirty-seven percent (37%) of adults exercised 5 or more days per week. Twenty-nine percent (29%) of adults did not participate in any physical activity in the past week, including 1% who were unable to exercise.

• Lucas County Latino adults spent the most time doing the following physical activities in the past year: walking (36%), exercise machines (8%), occupational exercise (3%), running/jogging (2%), cycling (2%), group exercise classes (2%), swimming (2%), and other (4%). Twenty-six percent (26%) of adults engaged in multiple types of exercise.

• Lucas County Latino adults reported the following would help them use community parks, bike trails, and walking paths more frequently: — More accessible parks, bike trails, and walking paths (35%) — Designated safe routes (29%) — Improvements to existing parks, trails, and paths (28%) — Better promotion and advertising of existing parks, trails, and paths (27%) — More public events and programs involving parks, trails, and paths (23%)

• Lucas County Latino adults reported the following reasons for not exercising: time (26%); self-motivation/will power (22%); too tired (21%); weather (19%); laziness (16%); pain or discomfort (12%); could not afford a gym membership (10%); no exercise partner (9%); no child care (6%); afraid of injury (6%); neighborhood safety (6%); choose not to exercise (5%); ill or physically unable (5%); do not like to exercise (4%); no walking, biking trails, or parks (4%); poorly maintained/no sidewalks (4%); too expensive (3%); did not know what activity to do (2%); no transportation to a gym or other exercise opportunity (2%); lack of opportunities for those with physical impairments or challenges (2%), and no gym available (1%).

Nutrition The table below indicates the number of servings of fruit, vegetables, sugar-sweetened beverages, and caffeinated beverages Lucas County Latino adults consumed daily.

5 or more servings

daily

3-4 servings

daily

1-2 Servings

daily

0 servings

daily

Fruit 0% 9% 78% 13%




• In 2019, 44% of Lucas County Latino adults ate 1 to 2 servings of fruits and/or vegetables per day, 34% ate 3 to

4 servings per day, and 16% ate 5 or more servings per day. Six percent (6%) of adults ate no servings of fruits and vegetables per day.

Adult Comparisons


2007


2011


2014


2017

Lucas County Latino 2020

Ohio Latinos

2018

U.S. Latinos

2018



33% 42% 49% 42% 51% 38% 34%

WEIGHT STATUS | 214

• Lucas County Latino adults reported they obtain their fresh fruits and vegetables from the following: — Large grocery store (such as Wal-Mart, Meijer, Kroger) (83%) — Farmers market (41%) — Local grocery store (such as Save-A-Lot) (25%) — Grow their own/garden (10%) — Food pantry (6%) — Dollar general/store (3%) — Veggie mobile/mobile produce (1%) — Mail order food services (such as Blue Apron) (1%) — Group purchasing, community supported agriculture (CSA) (1%) — Other (3%)

• Lucas County Latino adults reported the following barriers to consuming fruits and vegetables: too expensive (15%), they did not like the taste (5%), did not have access to fruits and vegetables (5%), did not know how to prepare (3%), no variety (2%), stores did not take EBT (1%), and other barriers (3%).

• Lucas County Latino adults reported the following reasons they chose the types of food they ate: — Taste/enjoyment (47%) — Cost (42%) — Healthiness of food (39%) — Food they were used to (37%) — Ease of preparation/time (35%) — What their family prefers (28%) — Availability (24%) — Nutritional content (22%) — Calorie content (13%) — If it is organic (10%) — Artificial sweetener content (8%) — If it is genetically modified (5%) — Other food sensitivities (5%) — Limitations due to dental issues (4%) — Availability at food panty (4%) — If it is lactose free (4%) — Health care provider’s advice (2%) — If it is gluten free (2%) — Limitations set by WIC (2%) — Other reasons (6%)

TOBACCO USE | 215

Health Behaviors: Latino Adult Tobacco Use Key Findings In 2020, 14% of Lucas County Latino adults were current smokers, and 30% were considered former smokers. One-fourth of (25%) Lucas County Latino adults used cigarettes in the past year. Forty-two percent (42%) of Lucas County Latino current smokers responded that they had stopped smoking for at least one day in the past year because they were trying to quit smoking.

Adult Tobacco Use Behaviors • Fourteen percent (14%) of Lucas County Latino adults were current smokers (those who indicated smoking at

least 100 cigarettes in their lifetime and currently smoked some or all days). • Thirty percent (30%) of Lucas County Latino adults indicated that they were former smokers (smoked 100

cigarettes in their lifetime and now do not smoke). • Lucas County Latino adult smokers were more likely to have:

— Been a member of an unmarried couple (55%) — Annual incomes less than $25,000 (17%) — Been ages 30-64 (16%)

• Lucas County Latino adults used the following tobacco products in the past year: cigarettes (25%); cigars (2%);

little cigars (2%); hookah (2%); cigarillos (1%); and chewing tobacco, snuff, or snus (1%). • Forty-two percent (42%) of Lucas County Latino current smokers responded that they had stopped smoking for

at least one day in the past year because they were trying to quit smoking.

• Lucas County Latino adults had the following rules/practices about smoking tobacco in their home: allowed only in certain rooms (3%), not allowed with children around (36%). Lucas County Latino adults had the following rules/practices about smoking tobacco in their car: allowed (5%), never allowed (87%), allowed only when one or more windows are open (4%), and not allowed with children around (5%).

• Lucas County Latino adults had the following rules/practices about using e-cigarettes/vapes in their home:

allowed only in certain rooms (2%), not allowed with children around (31%), and allowed anywhere (9%). Lucas County Latino adults had the following rules/practices about using e-cigarettes/vapes in their car: allowed (7%), never allowed (81%), allowed only when one or more windows are open (1%), and not allowed with children around (3%).

• Lucas County Latino adults reported they would support an ordinance to ban smoking in the following places:

— Vehicle with a minor present (73%) — Multi-unit housing (64%) — Rental homes (62%) — Parks or ball fields (62%) — Fairgrounds (60%) — College/university campuses (59%)

• Twenty percent (20%) of Lucas County Latino adults reported they would not support an ordinance to ban smoking anywhere.

• Lucas County Latino adults indicated e-cigarette vapor is harmful to the following: themselves (75%), others (71%), children (71%), an unborn child (73%) and not harmful to anyone (3%).

14% of Lucas County Latino adults were current smokers.

TOBACCO USE | 216

• Fifteen percent (15%) of adults did not know if e-cigarette vapor was harmful to themselves or others.

Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018


26% 25% 11% 26% 14% 29% 12%


18% 17% 22% 19% 30% 18% 18%

Tried to quit smoking N/A N/A N/A 41% 42% N/A N/A




TOBACCO USE | 217

The following graph shows Lucas County Latino adults’ smoking behaviors. Examples of how to interpret the information include: 14% of all Lucas County Latino adults were current smokers, 30% of all adults were former smokers, and 56% had never smoked.



14% 15% 14% 16%3%

17% 13%25%

11%

26%

30%20%

41%25%

37%

36%

26%

23%

22%

19%

56%65%

45%

59% 60%47%

61%52%

67%55%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income $25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Smoking Behaviors*



Health Behaviors: Adult Alcohol Consumption Key Findings More than half (53%) of Lucas County Latino adults had at least one alcoholic drink in the past month. More than one-third (37%) of Lucas County Latino adults reported they had five or more alcoholic drinks (for males) or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers. Adult Alcohol Consumption • More than half (53%) of Lucas County Latino adults had at least one alcoholic drink in the past month,

increasing to 64% of those with annual incomes of $25,000 or more. • Of those who drank, Lucas County Latino adults drank 4.4 drinks on average. • More than one-third (37%) of Lucas County Latino adults reported they had five or more alcoholic drinks (for

males or four or more drinks (for females) on an occasion in the last month and would be considered binge drinkers. Of those who drank in the past month, 70% had at least one episode of binge drinking.

• Twelve percent (12%) of Lucas County Latino adults reported driving after having perhaps too much alcohol to

drink in the past month, increasing to 17% of those ages 30-64.

• Lucas County Latino adults reported they or a family member experienced the following during the past 6 months: — Continued to drink despite problems caused by drinking (9%) — Drank more than they expected (7%) — Drove a vehicle or other equipment after having any alcoholic beverage (5%) — Tried to quit or cut down but couldn’t (5%) — Drank to ease withdrawal symptoms (5%) — Had legal problems (4%) — Spent a lot of time drinking (2%) — Had to drink more to get same effect (1%) — Placed themselves or their family in harm (2%) — Failed to fulfill duties at work, home, or school (1%) — Gave up other activities to drink (1%) — Used prescription drugs while drinking (1%)

• Lucas County Latino adults did not use a program or service to help with an alcohol problem for themselves or

a loved one for the following reasons: stigma of seeking alcohol services (5%), have not thought of it (2%), transportation (1%), fear (1%) do not want to get in trouble (1%), and other (5%). Eighty-seven percent (87%) of Lucas County Latino adults indicated that they did not need a program or service to help with an alcohol problem for themselves or a loved one.

37% of Lucas County Latino adults were considered binge drinkers.



Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018


47% 57% 51% 57% 53% 48% 46%


N/A 29% 25% 41% 37% 17% 18%


N/A N/A N/A 6% 12% N/A N/A


The following graph shows the percentage of Lucas County Latino adults consuming alcohol a in the past month. Examples of how to interpret the information include: 45% of all Lucas County Latino adults did not drink alcohol in the past month, including 56% of females and 71% of those with annual incomes less than $25,000.

*Percentages may not equal 100% as some respondents answered, “Don’t know.” Note for graph: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall

survey.

45%36%

56%44% 40%

71%

36%43% 44%

10%

4%

18%

15%

4%

3%

12%

25%14%

43%59%

24%38%

56%

26%

52%

32%37%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income $25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas County Latino Adults Average Number of Days Drinking Alcohol in the Past Month*


DRUG USE | 221

Health Behaviors: Latino Adult Drug Use

Key Findings Seven percent (7%) of Lucas County Latino adults had used recreational marijuana during the past 6 months. Six percent (6%) of Latino adults had used medication not prescribed for them or took more than prescribed to feel good or high and/or more active or alert during the past 6 months.

Adult Drug Use

• Lucas County Latino adults reported that they and/or an immediate family member/someone in their household used the following in the past 6 months: — Recreational marijuana or hashish (14%) — Medical marijuana (9%) — Amphetamines, methamphetamine or

speed (3%) — Cocaine, crack, or coca leaves (3%) — Inappropriate use of over-the-counter

medications (1%) — Heroin/fentanyl (1%)

— Ecstasy, E, or GHB (1%) — Inhalants (1%) — Synthetic marijuana/k2 (1%) — Wax, oil with THC edibles (12%) — Bath salts (2%) — LSD, mescaline, peyote, psilocybin, DMY, or

mushrooms (1%)

• Seven percent (7%) of Lucas County Latino adults reported using recreational marijuana or hashish in the past 6

months. • Lucas County Latino adults reported that they and/or an immediate family member/someone in their household

took the following medications not prescribed to them to feel good, high and/or more active or alert during the past 6 months: — Tranquilizers such as Valium or Xanax (11%) — Tramadol/Ultram (2%) — Steroids (3%) — OxyContin (6%) — Vicodin (7%)

— Codeine, Demerol, Morphine, Percocet, Dilaudid, or Fentanyl (4%)

— Suboxone or Methadone (2%) — Ritalin, Adderall, Concerta, or other ADHD

medication (11%) — Neurontin (2%)

• As a result of using drugs, Lucas County Latino adults indicated they or someone in their household

experienced the following: had legal problems (2%), failed a drug screen (2%), administered Narcan or nasal Naloxone (1%), regularly failed to fulfill obligations at work or home (1%), placed themselves in dangerous situations (1%), and overdosed and required EMS/hospitalization (1%).

• Three percent (3%) of Lucas County Latino adults reported being prescribed opioid based medication and had trouble stopping.

• Lucas County Latino adults did not use a program or service to help with a drug problem for themselves or a

loved one for the following reasons: could not afford to go (4%), insurance did not cover it (3%), a program was not available (3%), had not thought of it (2%), transportation (1%), fear (1%), stigma of seeking drug services (1%), did not want to get in trouble (1%), and other (4%). Ninety percent (90%) of Lucas County Latino adults indicated that they did not need a program or service to help with a drug problem for themselves or a loved one.

DRUG USE | 222


The following graphs indicate adult recreational marijuana use and prescription drug use in the past 6 months. An example of how to interpret the information on the first graph includes: 7% of Lucas County Latino adults used recreational marijuana in the past 6 months, including 9% of males and 6% of those with annual incomes less than $25,000.


Notes for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

Adult Comparisons




Lucas Latinos County 2017


Ohio Latinos 2018

U.S. Latinos 2018

Adults who used marijuana in the past six months 10% 10% 11% 9% 7% N/A N/A

Adults who misused prescription drugs in the past six months 4% 7% 11% 6% 6% N/A N/A

Adults who used heroin in the past six months

0% 0% 0% 0% 0% N/A N/A

7%

9%

5%

11%

4%

6%7%

10%11%

9%

0%

5%

10%

15%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Marijuana Use in the Past 6 Months

6%

1%

11%10%

0%

3%

6%7%

11%

6%

0%

5%

10%

15%

Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Medication Misuse in the Past 6 Months

DRUG USE | 223

24.1 23.6 23.3

16.3

41.7

11.2

16.8 17.6

27.8

22.6

0

10

20

30

40

50

2014 2015 2016 2017 2018

Per

100

,000

Po

pu

lati

on

Lucas County and Ohio Latino Age-Adjusted Unintentional Drug Overdose Deaths 2014-2018

Lucas County Ohio

The following graph shows the Lucas County and Ohio Latino age-adjusted unintentional drug overdose deaths from 2014 to 2018.

The following graph shows the number of Latino unintentional drug overdose deaths from 2014 to 2018 in Lucas County.

(Source for graphs: Ohio Public Health Data Warehouse, 2014-2018, Updated 12/11/19) Note Ohio Resident deaths include individuals that resided in Ohio at the time of death regardless of where the death occurred.

7 7 7

5

13

0

2

4

6

8

10

12

14

2014 2015 2016 2017 2018

Nu

mb

er o

f D

eath

s

Lucas County Latino Unintentional Drug Overdose Deaths, 2014-2018 Total Deaths=39


Health Behaviors: Latino Adult Sexual Behavior Key Findings Seventy-five percent (75%) of Lucas County Latino adults had sexual intercourse in the past year. Ten percent (10%) of Latino adults had more than one partner.


• Seventy-five percent (75%) of Lucas County Latino adults had sexual intercourse in the past year.

• Ten percent (10%) of Lucas County Latino adults reported they had intercourse with more than one partner in the past year, increasing to 13% of females.

• Lucas County Latino adults used the following methods of birth control: female sterilization (tubes tied) (16%);

they or their partner was too old to get pregnant (11%); birth control pills, any kind (9%); gay or lesbian (9%); male or female condoms (7%); contraceptive implant (e.g., Nexplanon) (6%); vasectomy (6%); withdrawal (3%); shots (e.g., Depo-Provera) (3%); practicing abstinence (2%); had ovaries or testicles removed (2%); hysterectomy (2%); IUD (1%); foam, jelly, film or cream (1%); and they or their partner is infertile (3%).

• Twelve percent (12%) of Lucas County Latino adults were not using any method of birth control, 2% were

pregnant and 2% were trying to get pregnant. • The following situations applied to Lucas County Latino adults: had sex without a condom in the past year

(26%); had anal sex without a condom in the past year (10%); had sexual activity with someone of the same gender (8%); had sex with someone they did not know (6%); treated for an STD in the past year (5%); had tested positive for HPV (5%); engaged in sexual activity following alcohol or other drug use that they would not have done if sober (5%); sex with someone they met on social media (3%); had four or more sexual partners in the past year (3%); tested positive for HIV (2%); used intravenous drugs in the past year (1%); and tested positive for Hepatitis C (1%).

• Eleven percent (11%) of Lucas County Latino adults were forced or coerced to have any type of unwanted sexual activity, increasing to 16% of females and 18% of those with annual incomes less than $50,000. Twenty-nine percent (29%) of those who were forced to have sexual activity reported it.


Adult Comparisons


2007


2011


2014



2020

Ohio Latinos

2018

U.S. Latinos 2018

Had more than one sexual partner in the past year

7% 10% 9% 14% 10% N/A N/A


The following graph shows the number of sexual partners Lucas County Latino adults had in the past year. Examples of how to interpret the information include: 65% of all Latino Lucas County adults had one sexual partner in the past year, 10% had more than one partner, and 24% did not have a sexual partner.

Respondents were asked: “During the past year, with how many different people have you had sexual intercourse?” *Totals may not equal 100% as some respondents answered, “Don’t know”.

Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey)

65% 67% 61%73%

33%43%

74% 69% 67%

10% 8%13%

8%

4%

9%

9%10% 9%

24% 24% 25% 18%

59%49%

16% 21% 24%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Lucas Latino2011

Lucas Latino2014

Lucas County Latino Number of Sexual Partners in the Past Year*



Latino Pregnancy Outcomes Note: Pregnancy outcome data includes all births to both adults and adolescents.

• From 2014 to 2019, there was an average of 518 live births per year in Lucas County.

*Note: Mothers Ethnicity = Latino (Source: Ohio Public Health Data Warehouse 2014-2018, Updated 8/16/2020)

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MENTAL HEALTH | 227

Health Behaviors: Latino Adult Mental Health Key Findings Four percent (4%) of Lucas County Latino adults considered attempting suicide in the past year. During the past year, 29% of Latino adults had a period of two or more weeks when they felt sad, blue or depressed. Adult Mental Health • During the past year, Lucas County Latino adults experienced the following almost every day for two weeks or

more in a row: did not get enough sleep or rest (43%); had high stress (36%); felt sad, blue or depressed (29%); felt worried, tense or anxious (27%); stopped during some usual activities (16%); had an unusual increase or loss of appetite (10%); and felt very healthy and full of energy (9%).

• Four percent (4%) of Lucas County Latino adults seriously considered attempting suicide in the past year.

• One percent (1%) of Lucas County Latino adults reported actually attempting suicide in the past year.

• Lucas County Latino adults reported they or someone in their household were diagnosed with or treated for the following mental health issues in the past year: anxiety or emotional problems (32%), anxiety disorder (panic attacks, phobia, obsessive-compulsive disorder) (27%), depression (26%), attention deficit/hyperactivity disorder (ADD/ADHD) (15%), post-traumatic stress disorder (PTSD) (9%), bipolar disorder (8%), psychotic disorder (schizophrenia, schizoaffective disorder) (6%), alcohol and illicit drug abuse (6%), autism spectrum (5%), other trauma (4%), developmental disability (3%), gambling problem (2%), eating disorder (2%), other mental health disorder (4%).

• Seventeen percent (17%) of Lucas County Latino adults indicated they or someone in their household had taken medication for one or more mental health issues.

• Lucas County Latino adults dealt with stress in the following ways: listened to music (43%), talked to someone

they trust (39%), prayed/meditated (29%), exercised (33%), ate more or less than normal (27%), slept (26%), drank alcohol (21%), worked (20%), worked on a hobby (10%), took it out on others (8%), smoked tobacco (5%), called a professional (5%), used illegal drugs (3%), used prescription drugs as prescribed (2%), and other ways (15%).

• The following prevented adults from using a program or service for themselves or a loved one in their

household to help with depression, anxiety, or emotional problems.: had not thought of it (13%), fear (7%), did not know how to find a program (7%), stigma of seeking mental health services (6%), co-pay/deductible too high (5%), transportation (4%), took too long to get in to see a doctor/health care provider (3%), could not afford to go (3%), could not get to the office or clinic (2%), other priorities (2%), and other reasons (5%). Fifty-three percent (53%) of adults indicated they did not need such a program and 8% indicated a program has been used.


Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018


N/A 7% 8% 7% 4% N/A N/A

4% of Lucas County Latino adults seriously considered attempting suicide in the past year.

MENTAL HEALTH | 228

The graph below shows the number of Latino suicide deaths by year in Lucas County.

The graphs below shows the number of Latino suicide deaths by gender from 2014 to 2018 in Lucas County.

(Source: ODH, Ohio Public Health Data Warehouse, Mortality, Leading Causes of Death, updated 1/29/2020)

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Chronic Disease: Latino Cardiovascular Health

Key Findings

Six percent (6%) of Lucas County Latino adults had survived a heart attack and 5% had survived a stroke at some time in their life. Fifty-one percent (51%) of adults were obese, 32% had high blood pressure, 21% had high blood cholesterol, and 14% were current smokers, which are four known risk factors for heart disease and stroke.

Heart Disease and Stroke • Two percent (2%) of Lucas County Latino adults reported

they were diagnosed with angina. • One hundred percent (100%) of those with angina were

receiving treatment for the diagnosis. • Six percent (6%) of Lucas County Latino adults reported

they had a heart attack. • Sixty-three percent (63%) of those who had a heart attack


• Five percent (5%) of Lucas County Latino adults reported they had a stroke.

• Twenty-nine percent (29%) of those who had a stroke reported currently receiving treatment for the diagnosis.

• Five percent (5%) of Lucas County Latino adults reported they had heart disease, increasing to 13% of those

over the age of 65. • Eighty-three percent (83%) of Lucas County Latino adults with heart disease were receiving treatment for it.


• Almost one-third (32%) of Lucas County Latino adults had been diagnosed with high blood pressure. Eighty-one percent (81%) of adults reported they were currently receiving treatment for the diagnosis.

• Eighty-eight percent (88%) of Lucas County Latino adults had their blood pressure checked within the past

year. • Lucas County Latino adults diagnosed with high blood pressure were more likely to have:

— Been classified as overweight or obese by body mass index (BMI) (100%) — Been age 65 years or older (60%) — Annual incomes less than $25,000 (36%)


• More than two-fifths (21%) of Lucas County Latino adults had been diagnosed with high blood cholesterol. Nearly three-quarters (74%) of adults reported they were currently receiving treatment for the diagnosis.

6% of Latino adults survived a heart attack or myocardial infarction.

Lucas County Latino Leading Causes of Death

2016-2018 Total Deaths: 328



Ohio Latino Leading Causes of Death

2016-2018 Total Deaths: 3,419




• Eighty-two percent (82%) of Lucas County Latino adults had their blood cholesterol checked within the past five years.

• Lucas County Latino adults with high blood cholesterol were more likely to have:

— Been classified as overweight or obese by body mass index (BMI) (96%) — Been ages 65 years or older (43%) — Annual incomes of $25,000 or higher (21%)

The following graphs show the number of Lucas County Latino adults who have been diagnosed with high blood pressure and high blood cholesterol. Examples of how to interpret the information on the first graph include: 32% of all Lucas County Latino adults have been diagnosed with high blood pressure, including 35% of males and 60% of those 65 years and older.



32%35%

27%

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LucasLatino 2020


Income$25K Plus

LucasLatino 2011

LucasLatino 2014

LucasLatino 2017

Lucas County Latino Adults Diagnosed with High Blood Pressure*

21%23%

18%

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Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Diagnosed with High Blood Cholesterol


The following graph demonstrates the percentage of Lucas County Latino adults who had major risk factors for developing cardiovascular disease (CVD).

Healthy People 2020 Objectives Heart Disease and Stroke (HDS)

Note: All U.S. figures age-adjusted to 2000 population standard. *Healthy People 2020 target is not race specific. (Source: Healthy People 2020, 2016 BRFSS, 2019/2020 Lucas County Health Assessment)

Objective

2020 Lucas County Latino

Survey Population

Baseline



32% 27%


82% 82%


21% 14%

32%

51%

29%

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Lucas County Latino Adults with Cardiovascular Disease Risk Factors


The following graph shows the percentage of Lucas County Latino adults who had survived a heart attack or stroke in their lifetime by gender. An example of how to interpret the information includes: 5% of Lucas County Latino males survived a heart attack compared to 7% of females.


Adult Comparisons


2007


2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018

Had angina 4% 2% 5% 3% 2% N/A 3%

Had a heart attack N/A 3% 4% 3% 6% N/A 4%

Had a stroke N/A 4% 2% 6% 5% N/A 2% Had been diagnosed with high blood pressure

21% 33% 28% 33% 32% N/A N/A


29% 25% 17% 17% 21% N/A N/A


64% 68% 73% 69% 82% N/A N/A


6%5%

7%

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7%

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2%

4%

6%

8%

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Total Male Female

Lucas County Latino Adults Who Had Survived a Heart Attack or Stroke In Their Lifetime

Heart Attack Stroke


The following graphs show the age-adjusted mortality rates per 100,000 population for heart disease and stroke. • When age differences are accounted for, the statistics indicate that the Lucas County Latino heart disease

mortality rate was higher than the figures for the state, the U.S., and Healthy People 2020 target from 2016 to 2018.

• The 2016 to 2018 Lucas County Latino age-adjusted stroke mortality rate was higher than the figures for the

state, the U.S., and Healthy People 2020 target. • From 2010 to 2018, the Lucas County Latina female and male age-adjusted heart disease mortality rates

fluctuated.

*The Healthy People 2020 Target objective for coronary heart disease is reported for heart attack mortality. (Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2016-2018, Healthy People 2020)


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Latino Adult Age-Adjusted Heart Disease and Stroke Mortality Rates

Lucas Latinos 2016-2018 Ohio Latinos 2016-2018


The following graph shows the age-adjusted mortality rates per 100,000 population for heart disease and stroke by the Latino and non-Latino population. The graph shows: • From 2016 to 2018, the age-adjusted stroke and heart disease mortality rates were higher in the non-Latino

population than the Latino population.


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CANCER | 235

Chronic Disease: Latino Cancer

Key Findings In 2020, 7% of Lucas County Latino adults had been diagnosed with cancer at some time in their life. The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 16% (54) of all (328) Lucas County Latino resident deaths.

Adult Cancer • Seven percent (7%) of Lucas County Latino adults

were diagnosed with cancer at some point in their lifetime, increasing to 25% of those over the age of 65.

• Of those diagnosed with cancer, they reported the

following types: prostate (33%), ovarian (33%), testicular (17%), leukemia (13%), head and neck (13%), renal (13%), and colon (13%).

• Lucas County Latino adults reported receiving the following cancer screenings:

— Colorectal cancer in the past five years (17%) — Oral cancer in the past year (11%) — Skin cancer in the past year (4%) — Lung cancer in the past three years (3%)

Cancer Facts • The Ohio Department of Health (ODH) indicates that, from 2016 to 2018, cancers caused 16% (54) of all (328)

Lucas County Latino resident deaths (Source: Ohio Public Health Data Warehouse, 2016-2018).


• ODH reports that liver and intrahepatic bile duct cancer (total deaths=8) caused 31% of Latino male cancer

deaths from 2016 to 2018. Lung and bronchus cancer (total deaths=1) caused 4% of Latino male cancer deaths from 2016 to 2018 in Lucas County. Colorectal cancer caused 1 male death, and cancer of the prostate caused 1 male death (Source: Ohio Public Health Data Warehouse, 2016-2018).

• ODH reports that colorectal cancer was the leading cause of Latina female cancer deaths (total deaths=6) in

Lucas County from 2016 to 2018, followed by lung and bronchus (total deaths=4), liver and intrahepatic bile duct cancer (total deaths=4), and breast cancer (total deaths=4) (Source: Ohio Public Health Data Warehouse, 2016-2018).

7% of Lucas County Latino adults were diagnosed with cancer at some point in their lifetime.

Lucas County Latino Incidence of Cancer, 2013-2017

All Types: 196 cases

• Colon and Rectum: 29 cases (15%) • Prostate: 25 cases (13%) • Breast: 17 cases (9%) • Liver: 17 cases (9%) • Lung and Bronchus: 11 cases (6%)

From 2016-2018, there were 54 Latino cancer deaths in Lucas County.

(Source: Ohio Cancer Incidence Surveillance System, and ODH Public Health Data Warehouse, Updated 2/7/2019)

CANCER | 236

The following graph shows the Lucas County, Ohio and U.S. age-adjusted mortality rates (per 100,000 population, 2000 standard) for all types of cancer in comparison to the Healthy People 2020 objective.

(Source: Ohio Public Health Data Warehouse, CDC Wonder, Healthy People 2020) *Healthy People 2020 target is not race specific.

The following graph shows cancer as a percent of total deaths in Lucas County Latino adults.


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Cancer as a Percent of All Total Deaths in Lucas CountyLatino Adults by Gender, 2016-2018

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Latino Adult Age-Adjusted Mortality Rates for All Cancersand Healthy People 2020 Objective


CANCER | 237

Breast Cancer

• Sixty percent (60%) of Lucas County Latina females reported having had a clinical breast examination in the past year.

• Sixty-nine percent (69%) of Lucas County Latina females over the age of 40 had a mammogram in the past year. • For women at average risk of breast cancer, recently updated American Cancer Society screening guidelines


The following graph shows the Latino Ohio and U.S. age-adjusted mortality rates per 100,000 populations for breast cancer in comparison with the Healthy People 2020 objective.

Note: Due to small numbers, the Lucas County Latina female age-adjusted mortality rate for breast cancer is not available (Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018)

*Healthy People 2020 target is not race specific

Prostate Cancer

• ODH statistics indicate that prostate cancer accounted for 4% of all Latino male cancer deaths from 2016 to

2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018). • No organizations presently endorse routine prostate cancer screening for men at average risk because of


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Ohio 2016-2018 U.S. 2016-2018 HP 2020 Target*

CANCER | 238

The following graph shows the Latino Ohio and U.S. age-adjusted mortality rates per 100,000 populations for prostate cancer in comparison with the Healthy People 2020 objective.


Note: Due to small numbers, the Lucas County Latino age-adjusted mortality rate for prostate cancer is not available

Lung Cancer • In Lucas County, 15% of Latino male adults were current smokers and 20% were former smokers. • According to the American Cancer Society, smoking causes 80% of Latino lung cancer deaths in the U.S. Men

and women who smoke are about 25 times more likely to develop lung cancer than nonsmokers (Source: American Cancer Society, Facts & Figures 2020).

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Ohio 2016-2018 U.S. 2016-2018 HP 2020 Target*

CANCER | 239

The following graphs show the Latino Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for lung and bronchus cancer in comparison with the Healthy People 2020 objective, as well as by gender.

*Healthy People 2020 Target data is for lung cancer only. Note: Lucas County year range includes 2014-2018 due to unavailable mortality rates from 2016-2018.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2015-2017)


Colorectal Cancer • ODH indicates that colorectal cancer accounted for 13% of all Latino male and Latina female cancer deaths

from 2016 to 2018 in Lucas County (Source: Ohio Public Health Data Warehouse, 2016-2018).



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CANCER | 240

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Colorectal Cancer as a Percent of Total Cancer Deaths in Lucas County Latino Adults by Gender, 2016-2018

The following graphs show Latino Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for colorectal cancer in comparison with the Healthy People 2020 objective, as well as by gender.

(Source: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2015-2017) *Healthy People 2020 target is not race specific.

Note: Lucas County year range includes 2014-2018 due to unavailable mortality rates from 2016-2018.


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CANCER | 241

Lucas County Latino Incidence of Cancer, 2013-2017

Types of Cancer Number of Cases Percent of Total

Incidence of Cancer Colon & Rectum 29 14.8% Prostate 25 12.8% Other Sites/Types 22 11.2% Breast 17 8.7% Liver & Intrahepatic Bile Duct 17 8.7% Lung and Bronchus 11 5.6% Kidney & Renal Pelvis 9 4.6% Thyroid 9 4.6% Bladder 7 3.6% Pancreas 7 3.6% Stomach 7 3.6% Leukemia 6 3.1% Non-Hodgkins Lymphoma 6 3.1% Uterus 6 3.1% Oral Cavity & Pharynx 5 2.6% Brain and Other CNS 4 2.0% Testis 3 1.5% Cervix 2 1.0% Esophagus 1 0.5% Melanoma of Skin 1 0.5% Multiple Myeloma 1 0.5% Ovary 1 0.5% Hodgkins Lymphoma 0 0.0% Larynx 0 0.0%

Total 196 100% (Source: Ohio Cancer Incidence Surveillance System, ODH Information Warehouse, Updated 2/7/20)

ARTHRITIS | 242

Chronic Disease: Latino Arthritis

Key Findings Eleven percent (11%) of Lucas County Latino adults were diagnosed with some form of arthritis.

Arthritis • Eleven percent (11%) of Lucas County Latino adults were told by a health professional that they had some form

of arthritis, increasing to 17% of those over the age of 65.

• Of those who were diagnosed, 93% were currently receiving treatment.

The following graph shows the percentage of Lucas County Latino adults who were diagnosed with arthritis. Examples of how to interpret the information include: 11% of Latino adults were diagnosed with arthritis, including 5% of males and 17% of adults ages 65 and older.


Adult Comparisons



2011


2014


2017


2020

Ohio Latinos

2018

U.S. Latinos

2018


11% of Lucas County Latino adults were diagnosed with arthritis.

11%

5%

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Lucas Latino2020


Income $25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Diagnosed with Arthritis

ASTHMA | 243

Chronic Disease: Latino Asthma Key Findings In 2020, 13% of Lucas County Latino adults were diagnosed with asthma. Asthma and Other Respiratory Disease • In 2020, 13% of Lucas County Latino adults were diagnosed with asthma, increasing to 15% of males.

• Seventy-one percent (71%) of Lucas County Latino adults with asthma were currently receiving treatment for

the diagnosis. • One percent (1%) of Lucas County Latino adults were diagnosed with chronic obstructive pulmonary disorder

(COPD).

• One hundred percent (100%) of Lucas County Latino adults were diagnosed with chronic obstructive pulmonary disorder (COPD) were currently receiving treatment.

• There are several important factors that may trigger an asthma attack. Some of these triggers are tobacco

smoke; dust mites; outdoor air pollution; cockroach allergens; pets; mold; smoke from burning wood or grass; and infections linked to the flu, colds, and respiratory viruses (Source: CDC, 2017).

• Chronic lower respiratory disease was the sixth leading cause of Latino deaths in Lucas County and the ninth

leading cause of Latino deaths in Ohio from 2016 to 2018 (Source: Ohio Public Health Data Warehouse, 2016-2018).

The following graph shows the percentage of Lucas County Latino adults who were diagnosed with asthma. Examples of how to interpret the information include: 13% of Latino adults were diagnosed with asthma, including 11% of females and 11% of adults with annual incomes less than $25,000.


Adult Comparisons






Ohio Latinos 2018

U.S. Latinos 2018

Diagnosed with asthma

13% 13% 15% 7% 13% 24% 13%

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LucasLatino 2020


Income$25K Plus

LucasLatino 2011

LucasLatino 2014

LucasLatino 2017

Lucas County Latino Adults Diagnosed with Asthma

ASTHMA | 244

The following graph shows the Latino Lucas County, Ohio, and U.S. age-adjusted mortality rates per 100,000 populations for chronic lower respiratory diseases (formerly COPD) in comparison with the Healthy People 2020 objective. The graph shows: • From 2014 to 2018, the Latino Lucas County age-adjusted mortality rate for chronic lower respiratory disease

was lower than the Ohio rate, U.S. rate, and the Healthy People 2020 target objective rate.

(Sources: Healthy People 2020, Ohio Public Health Data Warehouse 2016-2018, CDC Wonder 2016-2018) * Healthy People 2020’s target rate is for adults aged 45 years and older. Healthy People 2020 target is not race specific.

Note: Lucas County year range includes 2014-2018 due to unavailable mortality rates from 2016-2018.

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DIABETES | 245

Chronic Disease: Latino Diabetes

Key Findings In 2020, 13% of Lucas County Latino adults were diagnosed with diabetes at some point in their lifetime. Forty-one percent (41%) of Latino adults with diabetes rated their health as fair or poor.

Diabetes • Thirteen percent (13%) of Lucas County Latino adults were diagnosed with diabetes at some point in their

lifetime, increasing to 23% of those over the age of 65. • Ninety-four percent (94%) of Lucas County Latino adults diagnosed with diabetes were receiving treatment.

• A test for A1C measures the average level of blood sugar over the past three months. Seven percent (7%) of

Lucas County Latino adults reported getting their A1C checked three or more times in the past year. Four percent (4%) said two times, 27% said one time, 41% said none and 22% said they did not know if they had gotten their A1C checked within the past year.

• Forty-one percent (41%) of Lucas County Latino adults with diabetes rated their health as fair or poor. • Lucas County Latino adults diagnosed with diabetes also had one or more of the following characteristics or

conditions: — Overweight or obese (94%) — High blood pressure (24%) — High blood cholesterol (15%)

The following graph shows the percentage of Lucas County Latino adults who were diagnosed with diabetes. Examples of how to interpret the information include: 13% of Latino adults were diagnosed with diabetes, including 13% of females and 23% of adults ages 65 and older.


13% of Lucas County Latino adults were diagnosed with diabetes.

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Lucas Latino2020


Income$25K Plus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Diagnosed with Diabetes

DIABETES | 246

The following graphs show prevalence of diabetes by gender and the age-adjusted mortality rates from diabetes for Lucas County and Ohio residents with comparison to the Healthy People 2020 target objective. • From 2016 to 2018, Lucas County’s age-adjusted diabetes mortality rate was greater than the Ohio and U.S.

rates, but less than the Healthy People 2020 target objective.

*The Healthy People 2020 rate is for all diabetes-related deaths. Healthy People 2020 target is not race specific.

(Source: Ohio Public Health Data Warehouse, 2016-2018, CDC Wonder 2016-2018, Healthy People 2020)

Adult Comparisons






Ohio Latinos 2018

U.S. Latinos 2018


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Chronic Disease: Latino Quality of Life

Key Findings In 2020, 35% of Lucas County Latino adults were limited in some way because of a physical, mental or emotional problem. The most limiting health problems were back or neck problems (41%); stress, depression, anxiety or emotional problems (33%); sleep problems (31%); eye/vision problems (24%); and walking problems (22%).

Impairments and Health Problems • Thirty-five percent (35%) of Lucas County Latino Lucas County adults were limited in some way because of a

physical, mental or emotional problem.


— Back or neck problems (41%) — Stress, depression, anxiety, or emotional

problems (33%) — Sleep problems (31%) — Eye/vision problems (24%) — Arthritis/rheumatism (24%) — Walking problems (22%) — Chronic illness (20%) — Chronic pain (20%) — Fitness level (18%) — Fractures, bone/joint injuries (18%)

— Mental health illness/disorder (10%) — Lung/breathing problems (10%) — Hearing problems (8%) — Dental problems (8%) — Confusion (6%) — Memory loss (4%) — Learning disability (2%) — Substance dependency (2%) — Drug addiction (2%) — Other impairments/problems (4%)

• In the past year, Lucas County Latino adults reported needing the following services or equipment: eyeglasses or vision services (25%), canes (5%), help with routine needs (4%), help with personal care needs (4%), pain management (3%), hearing aids or hearing care (3%), personal emergency response systems (3%), medical supplies (2%), special beds (2%), walkers (2%), wheelchairs (2%), wheelchair ramps (2%), and oxygen or respiratory support (1%).

• Thirty-one percent (31%) of Lucas County Latino adults had fallen in the past year, increasing to 33% of those

65 and older.


Adult Comparisons


2007


2011




Ohio Latinos

2018

U.S. Latinos

2018

Limited in some way because of a physical, mental, or emotional problems

41% N/A 46% 40% 35% N/A N/A

35% of Lucas County Latino adults were limited in some way because of a physical, mental or emotional problem.


The following graphs show the percentage of Lucas County adults that were limited in some way and the most limiting health problems. Examples of how to interpret the information on the first graph include: 35% of Lucas County adults were limited in some way, including 53% of females and 35% of those ages 65 and older.


Healthy People 2020* Arthritis, Osteoporosis, and Chronic Back Conditions (AOCBC)

Objective

Lucas County Latino 2020



24% 36%

Note: U.S. baseline is age-adjusted to the 2000 population standard. *Healthy People 2020 target is not race specific. (Sources: Healthy People 2020 Objectives, 2019/2020 Lucas County Health Assessment)

41%33% 31%

24% 22%

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100%

Back/Neck Problems Stress, Depression,Anxiety, or Emotional

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Sleep Problems Eye/Vision Problems Walking Problems

Lucas County Latino Adults' Most Limiting Health Problems

35%

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53%

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Lucas Latino2020


Income $25KPlus

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults Limited in Some Way


Social Conditions: Latino Social Determinants of Health

Key Findings

In 2020, 5% of Lucas County Latino adults had to choose between paying bills and buying food. Twenty-seven percent (27%) of adults experienced four or more adverse childhood experiences (ACEs) in their lifetime. Twenty-six percent (26%) of Lucas County adults kept a firearm in or around their home.

Healthy People 2020



Economic Stability

• Lucas County Latino adults reported the following about their housing situation: — Had housing (89%) — Had housing, but were worried about losing housing in the future (8%) — Did not have housing (1%) — Don’t know (3%)

• Lucas County Latino adults attempted to get assistance from the following social service agencies: Job & Family

Services/JFS (14%), WIC/health department (6%), food pantries (5%), Pathway (5%), friend or family member (4%), place of worship (4%), United Way (2%), legal aid (2%), free clinic (1%), and other charities (1%). Four percent (4%) of Latino adults did not know where to look for assistance, and 5% did not qualify for assistance.

• Lucas County Latino adults experienced the following food insecurity issues during the past year: loss of income led to food insecurity issues (8%), worried food would run out (8%), had to choose between paying bills and buying food (5%), food assistance was cut (5%), went hungry/ate less to provide more food for their family (3%), and were hungry but did not eat because they did not have money for food (3%).

• Eight percent (7%) of Lucas County Latino adults experienced more than one food insecurity issue in the past year.

• The median household income in Lucas County was $49,448. The U.S. Census Bureau reports median income levels of $58,642 for Ohio and $65,712 for the U.S. (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

• Almost one-fourth (24%) of all Lucas County Latino residents were living in poverty (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimates).

• The unemployment rate for Lucas County was 10.6 as of July of 2020 (Source: Bureau of Labor Statistics, Local Area Unemployment Statistics).

• In Lucas County there were 203,795 housing units. The owner-occupied housing unit rate was 60%. Rent in Lucas County cost an average of $757 per month (Source: U.S. Census Bureau, 2019 American Community Survey 1-year Estimate).

7% of Lucas County Latino adults experienced more than one food insecurity issue in the past year.




Lucas County Latino adults and their loved ones needed the following assistance in the past year:

Type of Assistance Received Assistance

Did Not Know

Where to Look

Did Not Need

Assistance


Affordable child care 1% 8% 91%

Clothing 3% 7% 90%



Diapers 3% 2% 95%



Food 13% 8% 79%


Gambling addiction 0% 2% 98%





Medicare 9% 5% 86%





Septic/well repairs 0% 3% 97%


Unplanned pregnancy 0% 2% 98%

Utilities 2% 10% 88%


Social and Community Context • Lucas County Latino adults experienced the following in the past year:

— A close family member had to go to the hospital (47%) — Death of a family member or close friend (44%) — Had bills they could not pay (16%) — Someone in their household lost their job/had their hours at work reduced (14%) — Decline in their own health (13%) — Someone close to them had a problem with drinking or drugs (11%) — Moved to a new address (8%) — Knew someone who lived in a hotel (4%) — Was threatened or abused by someone physically, emotionally, sexually, and/or verbally (4%) — Their family as at risk for losing their home (4%) — Due to unforeseen circumstances, their household income was cut by 50% (4%) — They were a caregiver (4%) — Became separated or divorced (4%) — Their child was threated or abused by someone physically, emotionally, sexually, and/or verbally (3%) — Witnessed someone in their family being hit or slapped (2%) — Was homeless (1%)

• Lucas County Latino adults reported the following types of gambling: lottery/scratch-offs/office pools (35%);

casino gambling (19%); sports betting with a bookie/office pools (8%); fantasy sports/online betting (7%); poker or other card games, dice, or craps (not at a casino) (4%); and bingo (3%).

• Lucas County Latino adults reported engaging in some form of gambling:


• Lucas County Latino adults experienced the following due to gambling: consumed more alcohol or drugs when

gambling (1%) and felt the need to lie to hide the extent of their gambling (1%). • Nine percent (9%) of Lucas County adults were threatened with abuse in the past year by the following people:

a spouse or partner (58%), a child (33%), a parent (8%), another person living outside their home (8%), and someone else (25%).

• Five percent (5%) of Lucas County adults were abused (including physical, sexual, emotional, financial and verbal) in the past year by the following individuals: a spouse or partner (100%), another person from outside the home (29%), a parent (14%), and someone else (14%).


• Adverse childhood experiences (ACEs) are stressful or traumatic events, including abuse and neglect. They also include household dysfunction such as witnessed domestic violence or growing up with family members who have substance use disorders. ACEs are strongly related to the development of depression, alcoholism and alcohol abuse; depression; illicit drug use; chronic obstructive pulmonary disease; suicide attempts; and many other health problems throughout a person’s lifespan (SAMHA, Adverse Childhood Experiences, Updated on July 2, 2020).

• Lucas County Latino adults experienced the following adverse childhood experiences (ACEs):

— Lived with someone who was a problem drinker or alcoholic (36%) — Their parents became separated or were divorced (32%) — A parent or adult in their home swore at them, insulted them, or put them down (26%) — Someone at least five years older than them or an adult touched them sexually (23%) — Lived with someone who was depressed, mentally ill, or suicidal (22%) — A parent or adult in their home hit, beat, kicked, or physically hurt them (17%) — Their parents or adults in their home slapped, hit, kicked, punched, or beat each other up (16%) — Lived with someone who served time or was sentenced to serve time in prison, jail or correctional facility (16%) — Lived with someone who used illegal stress drugs, or who abused prescription medications (15%) — Their parents were not married (15%) — Their family did not look out for each other, feel close to each other, or support each other (11%) — Someone at least five years older than them or an adult tried to make them touch them sexually (10%) — They didn’t have enough to eat, had to wear dirty clothing, and had no one to protect them (7%) — Someone at least five years older than them or an adult forced them to have sex (5%)

• Twenty-seven percent (27%) of Latino adults experienced four or more adverse childhood experiences (ACEs).

The following graph shows the percentage of Lucas County Latino adults who had experienced four or more adverse child experiences (ACEs) in their lifetime. Examples of how to interpret the information on the graph include: 27% of all Lucas County Latino adults had experienced four or more ACEs in their lifetime, including 36% of females and 31% of those with annual incomes of $25,000 or higher.


27%

20%

36%

28%

3%

18%

31%

0%

10%

20%

30%

40%

50%

Lucas Latino 2020 Male Female 30-64 Years 65 & Over Income <$25K Income $25K Plus

Lucas County Latino Adults Who Experienced Four or More ACEs


The table below indicates correlations between Latino adults who experienced four or more ACEs in their lifetime and participating in risky behaviors, as well as other experiences. An example of how to interpret the information includes: 61% of Latino adults who experienced four or more ACEs had seriously contemplated suicide in the past year, compared to 11% of those who did not experience any ACEs.


Latino Adult Behaviors Experienced four or more

ACEs



85% 71%



Had two or more sexual partners (in the past year) 15% 9%



6% 6%

*ACEs indicate adults who self-reported having experienced four or more adverse childhood experiences in their lifetime. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.

Veterans Affair

• As a result of military service during the past 10-15 years, the following have affected Lucas County Latino veterans’ immediate family members: post-traumatic stress disorder (PTSD) (4%), access to medical care at a Veterans Affair facility (4%), major health problems due to injury (2%), marital problems (2%), had problems getting Veterans Affair benefits (2%), could not find/keep a job (2%), had problems getting information on Veterans Affair eligibility and applying (2%), substance/drug abuse/overdose (2%), and housing issues (2%).

Reactions to Race

• At work within the past year, 5% of Lucas County Latino adults felt they were treated worse than people of other races. More than half (53%) of Lucas County Latino adults felt they were treated the same, and 6% reported they were treated better than people of other races at work. Eleven percent (11%) of Latino adults reported they were treated worse than people of some races and better than people of other races at work.

• Within the past year, when seeking health care, 3% of Lucas County Latino adults felt their experiences in the

past year were worse than people of other races. Sixty-three percent (63%) of adults felt their experiences were the same, and 8% reported their experiences were better than people of other races when seeking health care. Three percent (3%) of Latino adults reported they were treated worse than people of some races and better than people of other races. When seeking health care.

• During the past month, 14% of Lucas County adults experienced physical symptoms (for example, a headache,

an upset stomach, tensing of muscles, or a pounding heart) as a result of how they were treated based on their race, increasing to 33% of those with incomes of $25,000 or more.

• Eighteen percent (18%) of Lucas County Latino adults reported feeling emotional distress (such as anger, sad,

frustrated) or was physical distress (such as experiencing a stomachache, headache, anxiety) as a result of how they were treated based on their race, ethnicity, sex, age, language, culture, religion, nationality, or sexual orientation in the past month.


• During the past month, Lucas County Latino adults felt emotionally upset as a result of how they were treated based off their: — Ethnicity (14%) — Culture (8%) — Skin color (7%) — Disability (5%) — Sexual orientation (3%) — Gender identity (1%) — Religion (1%)

Lucas County Latino Adults Experiences When Seeking Health Care*

Demographics Experiences When Seeking Health Care

Worse than Other Races

Better than Other Races

Same as Other Races

Don’t Know

Total (Latino) 2% 7% 57% 22%

White 1% 10% 53% 34% African American 9% 0% 47% 33%

*Percentages may not equal 100% due to the exclusion of data for those who did not have health care and answered multiple responses. Neighborhood and Built Environment

• Just over one-quarter (27%) of Lucas County Latino adults reported that their neighborhood was extremely safe, 43% reported it to be quite safe, 21% reported it to be slightly safe, and 7% reported it to be not safe at all. Two percent (2%) reported that they did not know how safe from crime their neighborhood was.

The following graph shows the percentage of Lucas County Latino adults who described their neighborhood as extremely safe, quite safe and slightly/not safe. Examples of how to interpret the information include: 27% of all Lucas County Latino adults described their neighborhood as extremely safe, including 31% of those with incomes less than $25,000.

*Respondents were asked: “How safe from crime do you consider your neighborhood to be?” Note: percentages may not equal 100% due to those who responded “don’t know”


27%39%

11%21% 21%

31%23%

12% 13%0%

43%

38%

51%

48% 48% 26%52%

40%50%

25%

8%21%

36%11% 8% 43%

24%

44%34%

70%

0%

20%

40%

60%

80%

100%

Lucas Latino2020


Income$25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adult Neighborhood Safety Perceptions*



• Sixty-two percent (62%) of Lucas County Latino adults reported deliberately testing all of the smoke detectors in their home within the past year. Eight percent (8%) have never tested the smoke detectors in their home.

• Eighteen percent (18%) of Lucas County Latino adults reported the following transportation issues: cost of

public or private transportation (36%), no car (27%), no driver’s license/suspended license (23%), no car insurance (23%), cannot afford gas (18%), other car issues/expenses (18%), disabled (18%), limited public transportation available or accessible (18%), no public transportation available or accessible (5%), and did not feel safe to drive (5%). Nine percent (9%) of adults who reported having transportation issues had more than one issue.

• Lucas County Latino adults indicated they use the following forms of transportation regularly: vehicle or family vehicle (88%), walk (13%), public transportation (9%), ride from a friend or family member (7%), bike (6%), and other (2%).

• Lucas County Latino adults reported doing the following while driving: talking on cell phone (57%); eating (37%); texting (36%); using cell phone other than for talking or texting (21%); used internet/apps/social media on cell phone (14%); texting (14%); driving without wearing a seatbelt (10%); being under the influence of alcohol (3%); being under the influence of recreational drugs (1%); reading (1%); and other activities (such as applying makeup, shaving, etc.) (4%). Of adult drivers, 52% had more than one distraction. Eleven percent (11%) of adults reported they did not drive.

• Twenty-six percent (26%) of Lucas County Latino adults kept a firearm in or around their home. No adult (0%)

reported that their firearms were unlocked and loaded.

• Lucas County Latino adults with firearms in or around their home reported the following reasons for having them: protection (46%), hunting or sport (41%), work (22%), and other reasons (12%).

The following graph shows the percentage of Lucas County Latino adults that have a firearm in or around the home. Example of how to interpret the information include: 26% of all Lucas County Latino adults had a firearm in or around the home, including 30% of males and 27% of those with annual incomes of $25,000 or lower.


survey.

26%

30%

22%

26%

21%

27%29%

18% 19%

24%

0%

10%

20%

30%

40%

Lucas Latino2020


Income $25KPlus

Lucas Latino2011

Lucas Latino2014

Lucas Latino2017

Lucas County Latino Adults With a Firearm in the Home

ENVIRONMENTAL HEALTH | 256

Social Conditions: Environmental Conditions Key Findings Lucas County Latino adults reported the following as the top four issues that threatened their health in the past year: bed bugs (10%), mold (8%), air quality (6%), and plumbing problems (5%). Ten percent (10%) of Lucas County Latino adults reported they had a disaster plan in preparation of a disaster. Environmental Health • Lucas County Latino adults thought the following threatened their or family members’ health in the past year:

— Bed bugs (10%) — Mold (8%) — Air quality (6%) — Rodents (5%) — Lice (5%) — Plumbing problems (5%) — Insects (4%) — Agricultural chemicals (3%) — Cockroaches (2%)

— Unsafe water supply/wells (2%) — Sewage/waste water problems (2%) — Temperature regulation (heating and air

conditioning) (2%) — Chemicals found in household products

(2%) — Moisture issues (2%) — Radon (2%)

• Fifteen percent (15%) of Lucas County Latino adults reported more than one environmental issue that

threatened their or family members’ health in the past year. Disaster Preparedness • Lucas County Latino households had the following disaster preparedness supplies: cell phone (87%),

working smoke detector (72%), computer/tablet (71%), working flashlight and working batteries (64%), three-day supply of water for everyone in the household (one gallon of water per person per day) (53%), three-day supply of nonperishable food for everyone in the household (52%), working carbon monoxide detector (49%), three-day supply of prescription medication for each person who takes prescribed medicines (41%), working battery-operated radio and working batteries (31%), communication plan (25%), home land-line telephone (18%), communication plan (13%), disaster plan (10%), and generator (8%).

• Eighty-seven percent (87%) of Lucas County Latino adults reported having more than one disaster preparedness supply. Eight percent (8%) of Lucas County Latino adults reported having none of the above disaster preparedness supplies.

10% of Latino adults reported that bed bugs threatened their or their family members’ health in the past year.

YOUTH WEIGHT STATUS | 257

Youth Health: Weight Status Key Findings Nearly one-fifth (17%) of Lucas County youth were obese, according to body mass index (BMI) by age. When asked how they would describe their weight, 29% of Lucas County youth reported that they were slightly or very overweight. Eighteen percent (18%) youth did not participate in at least 60 minutes of physical activity on any day in the past week. Twelve percent (12%) of youth reported they went to bed hungry at least one day per week because their family did not have enough money for food.

Youth Weight Status • Body mass index (BMI) for children is calculated differently from adults. The CDC uses BMI-for-age, which is

gender and age specific as children’s body fat changes over the years as they grow. In children and teens, BMI is used to assess underweight, normal, overweight, and obese.

• Nearly one-fifth (17%) of Lucas County youth were classified as obese by BMI calculations. Thirteen percent (13%) of youth were classified as overweight. Sixty-seven percent (67%) were normal weight, and 3% were underweight.

• Twenty-nine percent (29%) of youth described themselves as being slightly or very overweight. • Youth did the following to lose or keep from gaining weight in the past month:

Exercised (36%) Drank more water (35%) Ate more fruits (29%) Ate less food, fewer calories, or foods lower in fat (26%) Ate more vegetables (23%) Skipped meals (17%) Went without eating for 24 hours or more (6%) Vomited or took laxatives (2%) Took diet pills, powders, or liquids without a doctor’s advice (2%) Smoked cigarettes or e-cigarettes/vapes (1%) Used illegal drugs (1%)

• Thirty-nine percent (39%) of youth did not do anything to lose or keep from gaining weight.

Healthy People 2020 Nutrition and Weight Status (NWS)

Objective Lucas

County 2019

U.S. 2017


NWS-10.4 Reduce the proportion of children and adolescents aged 2 to 19 years who are considered obese

17% (6-12 Grade)

19%

(9-12 Grade)

15% (9-12 Grade)

15%

Note: The Healthy People 2020 target is for children and youth aged 2-19 years. (Sources: Healthy People 2020 Objectives, 2017 U.S. YRBS, 2019/2020 Lucas County Health Assessment)

7,344 Lucas County youth were classified as overweight or obese.


The following graph shows the percentage of Lucas County youth who were classified as obese, overweight, normal weight or underweight according to body mass index (BMI) by age. An example of how to interpret the information includes: 67% of all Lucas County youth were classified as normal weight, 17% were obese, 13% were overweight, and 3% were underweight.


Youth Nutrition • Twelve percent (12%) of youth reported they went to bed hungry at least one day per week because their

family did not have enough money for food. Two percent (2%) of youth went to bed hungry every night of the week.

• Twenty-seven percent (27%) of youth ate five or more servings of fruits and/or vegetables per day; 34% of youth ate three to four servings; and 33% of youth ate one to two servings. Six percent (6%) of youth ate zero servings of fruits and/or vegetables per day.

• Youth reported their family got most of their food from the following places: grocery store (94%), fast-food

restaurant (2%), convenience/corner store (1%), food pantry (1%), church/place of worship (<1%), and other (<1%).

The table below indicates the number of servings Lucas County youth had of fruit, vegetables, sugar-sweetened beverages and caffeinated beverages per day.

Five or more

servings

Three to four

servings

One to two servings

Zero servings

Fruit 7% 18% 65% 10%




17% 18% 16% 12%19% 22%

13%

13% 11% 15%15%

13% 10%11%

67% 67% 67% 70% 65% 67%71%

3% 4% 2% 3% 3% 1% 5%

0%

20%

40%

60%

80%

100%


Lucas County 6th-12th Grade Youth BMI Classifications

Obese Overweight Normal Weight Underweight


Youth Physical Activity • During the past week, youth participated in at least 60 minutes of physical activity at the following frequencies:

— Three or more days (61%) — Five or more days (40%) — Every day (21%) — Zero days (18%)

• Lucas County youth spent an average of 4.0 hours on a cell phone, 1.6 hours watching TV, 1.5 hours playing video games, and 1.4 hours on a computer/tablet on an average day of the week.

• One-fifth (20%) of youth spent three or more hours watching TV on an average school day.


Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Obese 17% 15% 13% 15% 19% 17% 16%

Overweight 13% 11% 11% 12% 12% 12% 16%


29% 25% 25% 30% 33% N/A 32%

Exercised to lose weight (in the past month)

36% 43% 48% 42% 36% N/A N/A

Ate less food, fewer calories, or foods lower in fat to lose weight (in the past month)

26% 28% 31% 26% 30% N/A N/A

Went without eating for 24 hours or more (in the past month)

6% 7% 6% 4% 6% N/A N/A

Took diet pills, powders, or liquids without a doctor’s advice (in the past month)

2% 3% 2% 1% 2% N/A N/A

Vomited or took laxatives (in the past month)

2% 3% 3% 1% 3% N/A N/A


67% 82% 81% 87% 70% N/A N/A


21% 28% 28% 23% 20% 23% 23%


40% 43% 50% 44% 40% 43% 44%


18% 15% 15% 14% 18% 21% 17%


20% 40% 34% 18% 18% N/A 20%

The CDC recommends that children and adolescents participate in at least sixty minutes of physical activity per day. As part of their sixty minutes per day; aerobic activity, muscle strengthening, and bone strengthening are three distinct types of physical activity that children should engage in, appropriate to their age. Children should participate in each of these types of activity on at least three days per week (Source: CDC Healthy Schools, November 14, 2018).

YOUTH TOBACCO USE | 260

Youth Health: Tobacco Use

Key Findings Three percent (3%) of Lucas County youth were current smokers (having smoked at some time in the past month). Twelve percent (12%) of youth used e-cigarettes/vapes in the past year. Of youth who had used e-cigarettes/vapes in the past year, 56% put e-liquid or e-juice with nicotine in them.

Youth Tobacco Use • Five percent (5%) of all Lucas County youth had tried cigarette smoking before the age of 13.

• Nearly one-fourth (24%) of those who had tried cigarette smoking did so at 10 years old or younger, and another 15% had done so by 12 years old. The average age of onset for smoking was 12.6 years old.

• Three percent (3%) Lucas County youth were current smokers, having smoked at some time in the past month.

• Nearly three-fourths (73%) of youth who identified as current smokers were also current drinkers, defined as having had a drink of alcohol in the past month.

• During the past year, 47% of youth who used tobacco tried to quit using all tobacco products, including cigarettes, cigars, smokeless tobacco, shisha or hookah tobacco, and electronic vapor products.

• Youth used the following forms of tobacco in the past year:

— E-cigarettes/vapes (e.g., JUUL) (12%) — Swishers (5%) — Black and Mild (4%) — Cigarettes (2%) — Hookah (2%)

— Cigarillos (1%) — Cigars (1%) — Chewing tobacco, snuff, or dip (1%) — Pouch (Snus) (1%) — Little cigars (<1%)

• Of youth that had used e-cigarettes/vapes in the past year, they reported putting the following in them:

— E-liquid or e-juice with nicotine (56%) — E-liquid or e-juice without nicotine (41%) — Marijuana or THC in the e-liquid (38%)

• Over two-fifths (41%) of youth thought there was a great risk in harming themselves physically or in other ways

if they used electronic vapor products. Thirteen percent (13%) of youth thought there was no risk in using electronic vapor products.

• Youth reported being exposed to secondhand smoke in the following places: home (23%), other relatives’ home (23%), car (19%), a friend’s home (10%), fairgrounds (5%), and park/ball field (4%).

6,048 Lucas County youth used e-cigarettes/vapes in the past year.


The following graphs show the percentage of Lucas County youth who were current smokers and those who used e-cigarettes/vapes in the past year. An example of how to interpret the information on the first graph includes: 3% of all Lucas County youth were current smokers, including 3% of males and 9% of those ages 17 and older.


3% 3%2%

1% 1%

9%

3%

0%

5%

10%

15%


Lucas County 6th-12th Grade Youth Who Were Current Smokers

12%11%

13%

5%

13%

25%

7%

0%

5%

10%

15%

20%

25%

30%


Lucas County 6th-12th Grade Youth Who Used E-Cigarettes/Vapes In the Past Year


Healthy People 2020 Tobacco Use (TU)

Note: The Healthy People 2020 target is for youth in grades 9-12. (Sources: Healthy People 2020 Objectives, 2017 U.S. YRBS, 2019/2020 Lucas County Health Assessment)

The table below indicates correlations between current smokers and participating in risky behaviors, as well as other activities and experiences. An example of how to interpret the information includes: 73% of current smokers had at least one drink of alcohol in their past month, compared to 11% of non-current smokers.

Behaviors of Lucas County Youth Current Smokers vs. Non-Current Smokers

“Current smokers” indicate youth who self-reported smoking at any time during the past month. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

Objective Lucas

County 2019

U.S. 2017


TU-2.2 Reduce use of cigarettes by adolescents (past month)

3% (6-12 Grade)

4%

(9-12 Grade)

9% (9-12 Grade)

16%

Youth Behaviors Current Smoker

Non-Current Smoker

Currently participate in extracurricular activities 75% 83%

Had at least one drink of alcohol (in the past month) 73% 11%

Had sexual intercourse (in their lifetime) 69% 17%

Felt sad or hopeless (almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past year)

68% 37%

Used marijuana (in the past month) 58% 10%

Bullied (in the past year) 56% 33%

Misused prescription medication (in the past month) 48% 6%

Seriously considered attempting suicide (in the past year) 46% 17%

Experienced three or more adverse childhood experiences (ACEs) (in their lifetime)

44% 25%

Attempted suicide (in the past year) 42% 9%


Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)

Lucas County

2013/14 (9th-12th)


Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Currently smoked cigarettes (on at least one day during the past month)

3% 18% 9% 5% 4% 5% 6%

First tried cigarette smoking before the age of 13 (even one or two puffs)

5% 6% 5% 4% 4% N/A 7%**

Tried to quit using all tobacco products (during the past year)

47% 46%* 40%* 34%* 31% N/A 48%

Currently frequently smoked cigarettes (on 20 or more days during the past month)

1% N/A N/A 2% 1% 1% 1%

*Tried to quit smoking only cigarettes N/A-Not Available **2018 U.S. YRBSS Data

E-Cigarettes and Youth: What Educators Need to Know

• What are e-cigarettes? E-cigarettes are battery-powered devices that deliver nicotine, flavorings, and other ingredients to the

user. E-cigarette use is sometimes called “vaping.” E-cigarettes do not create harmless water vapor – they create an aerosol that contains harmful chemicals.

Since 2014, e-cigarettes are the most commonly used tobacco product among youth. In 2018, the CDC and FDA data indicated that more than 3.6 million youth in the U.S. were past month

e-cigarette users. From 2017-2018, e-cigarette use skyrocketed, leading the U.S. Surgeon General to call the use of these

products an epidemic.

• What are the risks for youth? 1. Most e-cigarettes contain nicotine, which is highly addictive. Nicotine exposure can cause harmful brain

development; impact learning, memory, and attention; and increase risk for future addiction to other drugs.

2. Young people who use e-cigarettes may be more likely to use regular cigarettes. 3. E-cigarette aerosol may contain substances including cancer causing chemicals, flavorings that have

been linked to lung disease, heavy metals such as tin, nickel and lead, etc.

(Source: CDC, Smoking and Tobacco Use, 12/5/19)

YOUTH ALCOHOL CONSUMPTION | 264

Youth Health: Alcohol Consumption

Key Findings In 2019, 12% of youth had at least one drink in the past month, defining them as a current drinker. Of those who drank, 57% were defined as binge drinkers. Fourteen percent (14%) of all Lucas County youth had ridden in a car driven by someone who had been drinking alcohol in the past month.

Youth Alcohol Consumption • Twelve percent (12%) of Lucas County youth had at least one drink in the past month, increasing to 27% of

those ages 17 and older.

• Based on all youth surveyed, 7% had five or more alcoholic drinks on an occasion in the last month and would be considered binge drinkers, increasing to 17% of those ages 17 and older. Of those who drank, 57% were defined as binge drinkers.

• Of all youth, 12% had drunk alcohol for the first time before the age of 13.

• Over one-third (37%) of youth who reported drinking at some time in their life had their first drink at 12 years old or younger, 30% took their first drink between the ages of 13 and 14, and 34% started drinking between the ages of 15 and 18. The average age of onset was 13.1 years old.

• Youth drinkers reported the following ways of obtaining their alcohol: — Someone gave it to them (34%) — An older friend or sibling bought it for them (23%) — A parent gave it to them (18%) — Someone older bought it (16%) — Took it from a store or family member (11%) — A friend’s parent gave it to them (6%) — Bought it in a liquor store, convenience store, supermarket, discount store, or gas station (4%) — Used a fake ID (2%) — Some other way (24%)

• During the past month, 14% of all Lucas County youth had ridden in a car driven by someone who had been

drinking alcohol.

• Four percent (4%) of youth drivers had driven in a car in the past month after they had been drinking alcohol.

Healthy People 2020 Substance Abuse (SA)

Objective Lucas

County 2019

U.S. 2017


SA-14.4 Reduce the proportion of persons engaging in binge drinking during the past month

7% (6-12 Grade)

12%

(9-12 Grade)

14% (9-12 Grade)

9%

Note: The Healthy People 2020 target is for youth aged 12-17 years. (Sources: Healthy People 2020 Objectives, 2017 U.S. YRBS, 2019/2020 Lucas County Health Assessment)

24,623 youth were considered binge drinkers.


The following graphs show the percentage of Lucas County youth who were current drinkers and youth who binge drank in the past month. An example of how to interpret the information on the first graph includes: 12% of all Lucas County youth were current drinkers, including 15% of females and 27% of youth 17 and over.

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that


12%

9%

15%

6%

13%

27%

17%

0%

5%

10%

15%

20%

25%

30%


Lucas County 6th-12th Grade Youth Who Were Current Drinkers

7%

4%

10%

2%

8%

17%

7%

0%

5%

10%

15%

20%


Lucas County 6th-12th Grade Youth Binge Drinking in Past Month


The table below indicates correlations between current drinkers and participating in risky behaviors, as well as other activities and experiences. An example of how to interpret the information includes: 51% of current drinkers had sexual intercourse in their lifetime, compared to 14% of non-current drinkers.

Behaviors of Lucas County Youth

Current Drinkers vs. Non-Current Drinkers

“Current drinkers” indicate youth who self-reported having had at least one drink of alcohol during the past month. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

Youth Behaviors Current Drinker

Non-Current Drinker



60% 35%


51% 21%



Have used marijuana (in the past month) 39% 8%




Smoked cigarettes (in their lifetime) 14% 1%

Preventing Teen Drinking and Driving: What Works?

• Minimum legal drinking age (MLDA) laws in every state make it illegal to sell alcohol to anyone under the age of 21. Research has shown that enforcement of MLDA laws, including compliance checks, has reduced retail sales of alcohol to those under the legal age.

• Zero tolerance laws make it illegal for those under age 21 to drive after drinking any alcohol. Research has shown that these laws have reduced drinking and driving crashes among teens.

• Graduated driver licensing (GDL) systems help new drivers get more experience under less risky conditions. As teens move throughout the different stages, they gain more privileges (such as driving at night, driving with a passenger, etc.). Every state has a GDL system, but the rules may differ from state to state. Research indicates GDL systems prevent crashes.

• Parent involvement, with a focus on monitoring and restricting what new drivers are allowed to do, helps keep teens safe as they learn to drive. Parents may consider creating and signing a parent-teen driving agreement with their teens. Research shows when parents enforce rules, new drivers report lower rates of risky driving, crashes, and violations.

(Source: CDC, Teen Drinking and Driving, updated on August 2, 2018)



Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th–12th)

Current drinker (at least one drink of alcohol on at least one day during the past month)

12% 39% 28% 27% 19% 26% 29%


7% 23% 21% 13% 12% 13% 14%

Obtained the alcohol they drank by someone giving it to them (of youth drinkers)

34% 21% 14% N/A 31% N/A 41%


14% 25% 21% 19% 14% N/A 17%


4% 9% 5% 6% 4% N/A 5%

Drank for the first time before age 13 (of all youth)

12% 18% 12% 8% 8% 16% 15%

YOUTH DRUG USE | 268

Youth Health: Drug Use Key Findings Twelve percent (12%) of Lucas County youth had used marijuana at least once in the past month. Twelve percent (12%) of youth used Ritalin, Adderall, Concerta, or other ADHD medications not prescribed for them or took more than was prescribed to feel good or get high at some time in their lifetime.

Youth Drug Use • Twelve percent (12%) of Lucas County youth had used marijuana or hashish at least once in the past month,

increasing to 20% of those ages 17 and over.

• Six percent (6%) of youth had tried marijuana for the first time before the age of 13, increasing to 7% of females.

• Youth who misused prescription medications got them in the following ways: a parent gave it to them (62%), a friend gave it to them (23%), bought it from someone else (12%), another family member gave it to them (12%), bought it from a friend (11%), took it from a friend or family member (8%), and the Internet (5%).

• Lucas County youth had tried the following in their life: — Liquid THC (5%) — Misused cough syrup (3%) — Inhalants (2%) — Posh/salvia/synthetic marijuana (2%) — Misused over-the-counter medication

(2%) — Steroid pills, creams, or shots without a

doctor’s prescription (1%)

— Ecstasy/MDMA/Molly (1%) — Bath salts (<1%) — Went to a pharm party/skittles (<1%) — Cocaine (<1%) — K2/spice (<1%) — Misused hand sanitizer (<1%)

• Youth used the following medications in their life that were not prescribed to them or took more than

prescribed to feel good or high, more active or alert: Ritalin, Adderall, Concerta, or other ADHD medications (12%); tranquilizers (6%); Codeine, Demerol, Morphine, Percodan or Dilaudid (2%); OxyContin (2%), Vicodin (2%); Fentanyl (2%); steroids (1%); and Ultram (1%).

• Youth reported the following would keep them from seeking help to quit using alcohol, tobacco, or other drugs: might get in trouble (21%), don’t know where to go (16%), time (10%), cost (7%), and transportation (3%). Fifty-two percent (52%) of youth reported that they do not think they need help, and 11% reported they did not want to quit.

5,184 Lucas County youth were current marijuana users.


The following graphs show youth lifetime drug use and youth marijuana use in the past month. An example of how to interpret the information on the first graph includes: 2% of youth used inhalants at some point in their life, including 2% of males and 1% of females. Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

12%

9%

14%

3%

16%

20%

10%

0%

5%

10%

15%

20%

25%


Lucas County 6th-12th Grade Youth Marijuana Use in Past Month

1%

2%

<1%

0% 0%

1%

2%

<1%

0% 0%

<1% 1% <1%

0% 0%

1%

2%

1% 1% 1%

0%

1%

2%

3%

4%

5%

Steroids Inhalants Cocaine Heroin Meth

Lucas County Youth Lifetime Drug Use

Lucas '19-20 Male Female Lucas 2019


The table below indicates correlations between 30-day marijuana use and participating in risky behaviors, as well as other activities and experiences. An example of how to interpret the information includes: 54% of current marijuana users had sexual intercourse in their lifetime, compared to 14% of non-current marijuana users.

Behaviors of Lucas County Youth

Current Marijuana Use vs. Non-Current Marijuana Use

“Current marijuana use” indicates youth who self-reported using marijuana at any time during the past month. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Currently used marijuana (in the past month)

12% 26% 19% 18% 16% 16% 22%

Ever used cocaine (in their lifetime)

<1% 4% 3% 2% <1% 4% 4%

Ever used heroin (in their lifetime) 0% 2% 1% 1% 0% 2% 2%


0% 3% 2% 1% 0% N/A 2%


1% 4% 4% 1% 1% N/A 2%

Ever used inhalants (in their lifetime)

2% 9% 5% 3% 2% 8% 6%


1% N/A 3% 2% 1% N/A 4%

N/A-Not Available

Youth Behavior Current

Marijuana User

Non-Current

Marijuana User



73% 34%



49% 22%





Rise in Prescription Drug Misuse and Abuse Impacting Teens

• Prescription drug abuse is the fastest-growing drug problem in the U.S. and impacts teen’s mental and physical health. A common misperception is that these drugs are safer to use than other types of drugs. However, there are many short- and long-term health consequences for each type of prescription drug used inappropriately:

Stimulants have side effects common with cocaine and can include paranoia, high body temperatures, and irregular heartbeat.

Opioids, which act on the same part of the brain as heroin, can cause drowsiness, nausea, constipation, and slowed breathing.

Depressants can cause slurred speech, shallow breathing, disorientation, lack of coordination, and even seizures upon withdrawal of chronic use.

• The above impacts are particularly harmful to a developing teen brain and body. Our brains are still developing until our early to mid-twenties. As with any type of mind-altering drug, prescription drug misuse or abuse can affect judgement and inhibition, putting teens at a higher risk for HIV and other sexually transmitted infections, misusing other drugs, and engaging in additional risky behaviors.

(Source: SAMHSA, Rise in Prescription Drug Misuse and Abuse Impacting Teens, updated on 7/22/20)

PERCEPTIONS OF SUBSTANCE USE | 272

Youth Health: Perceptions of Substance Use

Key Findings

In 2019, 74% of Lucas County youth thought there was a great risk in harming themselves if they used prescription drugs not prescribed to them. Seventy-eight percent (78%) of youth reported their parents would disapprove of them smoking cigarettes.

Perceived Risk of Substance Use

• Sixty-eight percent (68%) of Lucas County youth thought there was a great risk in harming themselves physically or in other ways if they smoked cigarettes.

• Sixty-eight percent (68%) of youth thought there was a great risk in harming themselves physically or in other ways if they drank alcohol.

• Sixty-two (62%) of youth thought there was a great risk in harming themselves physically or in other ways if

they used e-cigarettes/vapes. • Over half (55%) of youth thought there was great risk in harming themselves physically or in other ways if

they smoked marijuana. • Nearly three-fourths (74%) of youth thought there was a great risk in harming themselves physically or in

other ways if they used prescription drugs not prescribed to them. Degree of Disapproval of Use by Parents

• Seventy-eight percent (78%) of Lucas County youth reported their parents would disapprove of them smoking cigarettes, increasing to 81% of youth under the age of 13.

• Seventy-two percent (72%) of youth reported their parents would disapprove of them drinking alcohol, decreasing to 60% of those ages 17 and older.

• Three-fourths (75%) of youth reported their parents would disapprove of them using e-cigarettes/vapes,

decreasing to 69% of those ages 17 and older. • Seventy-four percent (74%) of youth reported their parents would disapprove of them smoking marijuana,

decreasing to 62% of those ages 17 and older. • Nearly four-fifths (79%) of youth reported their parents would disapprove of them using prescription drugs

not prescribed to them. Degree of Disapproval of Use by Peers

• Sixty-nine percent (69%) of Lucas County youth reported their peers would disapprove of them smoking cigarettes, increasing to 73% of youth under the age of 13.

• Forty-eight percent (48%) of youth reported their peers would disapprove of them drinking alcohol, decreasing to 24% of those ages 17 and older.

• Fifty-three percent (53%) of youth reported their peers would disapprove of them to using e-cigarettes/vapes,

decreasing to 33% of those ages 17 and older. • Nearly half (49%) of youth reported their peers would disapprove of them to smoking marijuana, decreasing

to 32% of those ages 17 and older. • Sixty-eight percent (68%) of youth reported their peers would disapprove of them using prescription drugs

not prescribed to them.


Youth Comparisons

Lucas County 2011

(7th-12th)

Lucas County

2013/14 (7th-12th)


Lucas County 2019

(9th-12th)

Perceived Degree of Great Disapproval by Parents

Smoke cigarettes 82% 78% 81% 76%

Use e-cigarettes/vapes N/A N/A 76% 73%

Drink alcohol 63% 74% 73% 69%

Use marijuana 83% 79% 78% 69%

Misuse prescription drugs N/A 83% 81% 78%

Perceived Degree of Great Disapproval by Peers

Smoke cigarettes N/A 45% 71% 66%


Drink alcohol N/A 40% 53% 37%

Use marijuana N/A 41% 58% 38%

Misuse prescription drugs N/A 58% 72% 65%

Perceived Great Risk of Substance Use

Smoke cigarettes 62% 64% 69% 68%


Drink alcohol 28% 39% 69% 70%

Use marijuana 43% 28% 57% 48%

Misuse prescription medication N/A 58% 75% 76% N/A – Not Available


Lucas County Youth Perceived Risk of Use Do you believe people risk

harming themselves if they: Total Male Female

13 and younger

14-16 years old

17 and older

Smoke cigarettes 68% 66% 70% 70% 69% 63%

Use e-cigarettes/vapes 62% 59% 64% 66% 59% 59%

Drink alcohol 68% 63% 72% 67% 69% 69%

Use marijuana 55% 51% 59% 67% 51% 38%

Misuse prescription drugs 74% 67% 79% 74% 75% 74%

Lucas County Youth Perceived Disapproval by Parents

Parent would disapprove for you to do the following:

Total Male Female 13 and

younger 14-16

years old 17 and older



Drink alcohol 72% 66% 77% 77% 71% 60%

Use marijuana 74% 69% 78% 81% 72% 62%


Lucas County Youth Perceived Disapproval by Peers

Friend would dispppove for you to do the following:

Total Male Female 13 and

younger 14-16

years old 17 and older



Drink alcohol 48% 47% 49% 63% 44% 24%

Use marijuana 49% 47% 51% 64% 43% 32%


YOUTH SEXUAL BEHAVIOR | 275

Youth Health: Sexual Behavior

Key Findings Nineteen (19%) of Lucas County youth had sexual intercourse in their lifetime. Eighteen percent (18%) of sexually active youth had four or more sexual partners in their lifetime. Six percent (6%) youth engaged in intercourse without a reliable method of protection, and 30% reported they were unsure if they used a reliable method.

Youth Sexual Behavior

• Nearly one-fifth (19%) of Lucas County youth had sexual intercourse in their lifetime, increasing to 41% of those ages 17 and over.

• About one-fifth (17%) of youth had participated in oral sex, increasing to 38% of those ages 17 and over.

• Three percent (3%) of youth had participated in anal sex, increasing to 9% of those ages 17 and over.

• One-fifth (20%) of youth had participated in sexting, increasing to 36% of those ages 17 and over.

• Twenty-three percent (23%) of youth had viewed pornography, increasing to 37% of those ages 17 and over and 31% of males.

• Of sexually active youth, 47% had one sexual partner, and 53% had multiple partners in their lifetime.

• Eighteen percent (18%) of sexually active youth had four or more sexual partners in their lifetime.

• Four percent (4%) of all youth had four or more sexual partners in their lifetime.

• Of those youth who were sexually active, 22% had engaged in intercourse by the age of 13. Another 51% had done so by 15 years of age. The average age of onset was 14.6 years old.

• Of all youth, 2% were sexually active before the age of 13.

• Lucas County youth reported they or their partner used the following methods to prevent pregnancy the last time they had sexual intercourse: condoms (31%); birth control pills (10%); an IUD or implant (8%); a shot, patch or birth control ring (5%); withdrawal method (3%); and some other method (4%). Five percent (5%) of youth reported they were gay or lesbian. However, 6% engaged in intercourse without a reliable method of protection, and 30% reported they were unsure.

• Youth reported they or their partner used the following methods to prevent sexually transmitted diseases (STDs) the last time they had sexual intercourse: condoms (47%), they were in a mutually monogamous relationship (18%), they/their partner got tested (8%), avoided alcohol/recreation drug use (3%), abstinence (3%), and some other method (2%).

• Lucas County youth had experienced the following in their lifetime: had sexual contact with a female (13%); had sexual contact with a male (12%); wanted to get pregnant (3%); got someone pregnant (1%); had sex in exchange for something of value such as food, drugs, shelter or money (1%); had a miscarriage (1%); been pregnant (1%); had a child (1%); tried to get pregnant (1%), and had been treated for an STD (<1%);

8,208 youth had sexual intercourse in their lifetime.


The following graphs show the percentage of Lucas County youth who participated in sexual intercourse and oral sex in their lifetime. An example of how to interpret the information on the first graph includes: 19% of all Lucas County youth had sexual intercourse, including 25% of those 14 to 16 and 41% of those ages 17 and older.


19% 18%20%

2%

25%

41%

29%

0%

10%

20%

30%

40%

50%


Lucas County 6th-12th Grade Youth Who Had Sexual Intercourse in their Lifetime

17% 17% 18%

2%

23%

38%

23%

0%

10%

20%

30%

40%

50%


Lucas County 6th-12th Grade Youth Who Participated in Oral Sex in their Lifetime


The following graphs show the percentage of Lucas County youth who participated in anal sex and sexting. An example of how to interpret the information on the first graph includes: 3% of all Lucas County youth had anal sex, including 5% of males and 9% of those 17 and older.


3%

5%

2%1%

4%

9%

6%

0%

5%

10%

15%


Lucas County 6th-12th Grade Youth Who Participated in Anal Sex in their Lifetime

20%18%

21%

5%

27%

36%

25%

0%

10%

20%

30%

40%

50%


Lucas County 6th-12th Grade Youth Who Participated in Sexting in their Lifetime



Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)

Lucas County

2013/14 (9th-12th)


Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Ever had sexual intercourse 19% 63% 53% 42% 32% 38% 38%

Participated in anal sex 3% 16% 6% 8% 5% N/A N/A

Participated in oral sex 17% 46% 44% 35% 30% N/A N/A

Participated in sexting 20% 40% 34% 37% 31% N/A N/A

Had viewed pornography 23% N/A 37% 42% 31% N/A N/A

Used a condom (during last sexual intercourse)

31% 75% 68% 58% 24% 45% 54%


10% 20% 26% 15% 9% 32% 23%


8% 8% 7% 1% 7% 5% 5%

Used a shot, patch or birth control ring (during last sexual intercourse)

5% 8% 7% 3% 5% N/A N/A


6% 7% 10% 13% 5% 12% 12%


4% 27% 21% 15% 8% 8% 9%


2% 12% 10% 7% 2% 3% 3%

Sexual Risk Behavior

• Many young people engage in sexual risk behaviors that can result in unintended health outcomes. For example, among U.S. high school students surveyed in 2017: — Less than 10% of sexually experienced students have ever been tested for HIV. — 40% had ever had sexual intercourse. — 7% had been physically forced to have sexual intercourse when they did not want to.

• Of the 30% of youth who were sexually active in the past three months: — 46% did not use a condom the last time they had sex. — 14% did not use any method to prevent pregnancy. — 19% had drank alcohol or used drugs before last sexual intercourse.

• Sexual risk behaviors place adolescents at risk for HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancy.

• Young people (aged 13-24) accounted for an estimated 21% of all new HIV diagnoses in the United States in 2017.

• Among young people (aged 13-24) diagnosed with HIV in 2017, 87% were males.

• Half of the nearly 20 million new STDs reported each year are among young people, between the ages 15–24.

• Nearly 210,000 babies were born to teen girls aged 15-19 years in 2016.

(Source: CDC, Adolescent and School Health, Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention, Updated March 25, 2020)

YOUTH MENTAL HEALTH | 279

Youth Health: Mental Health

Key Findings

Seventeen percent (17%) of youth had seriously considered attempting suicide in the past year, and 10% attempted suicide in the past year. Over two-fifths (41%) of Lucas County youth reported academic success caused them anxiety, stress, or depression. One-fourth (25%) of youth had experienced three or more adverse childhood experiences (ACEs) in their lifetime.

Youth Mental Health

• Thirty-eight percent (38%) of Lucas County youth reported they felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities, increasing to 47% of females.

• Seventeen percent (17%) of youth reported they had seriously considered attempting suicide in the past year, increasing to 23% of females.

• In the past year, 10% of Lucas County youth had attempted suicide, increasing to 12% of females. Seven percent (7%) of youth had made more than one attempt.

• Youth reported the following caused them anxiety, stress or depression: academic success (41%), death of close family member or friend (33%), fighting with friends (30%), self-image (29%), other stress in the home (28%), fighting at home (24%), sports (23%), peer pressure (20%), breakup (20%), dating relationship (20%), being bullied (16%), social media (14%), poverty/no money (14%), parent divorce/separation (11%), sick parent (10%), caring for younger sibling (9%), current news/world events/political environment (9%), alcohol or drug use in the home (5%), not having enough to eat (5%), sexual orientation (3%), not having a place to live (3%), gender identity (2%), and other (14%).

• Youth reported the following ways of dealing with anxiety, stress, or depression: sleeping (50%), texting someone (30%), engaging in hobbies (29%), eating (25%), eat more/less than normal (24%), exercising (20%), talking to someone in their family (19%), talking to a peer (19%), using social media (13%), writing in a journal (12%), shopping (10%), breaking something (10%), praying/reading the Bible (7%), and drinking alcohol/smoke/use tobacco/use illegal drugs (6%). Nineteen percent (19%) of youth reported they did not have anxiety, stress, or depression.

• Youth reported the following adverse childhood experiences (ACEs): — Parents became separated or were divorced (30%) — Parents or adults in home swore at them, insulted them or put them down (23%) — Family did not look out for each other, feel close to each other, or support each other (19%) — Parents were not married (17%) — Lived with someone who was depressed, mentally ill or suicidal (17%) — Lived with someone who was a problem drinker or alcoholic (15%) — Lived with someone who served time or was sentenced to serve in prison or jail (14%) — Lived with someone who used illegal drugs or misused prescription drugs (9%) — Parents or adults in home slapped, hit, kicked, punched or beat each other up (8%) — Parents or adults in the home hit, beat, kicked, or physically hurt them in any way (not including

spanking) (6%) — Did not have enough to eat, had to wear dirty clothes, and had no one to protect them (4%) — An adult or someone five years older than them touched them sexually (3%) — An adult or someone five years older than them made them touch them sexually (2%) — An adult or someone five years older than them forced them to have sex (1%)

• One-fourth (25%) of youth had experienced three or more ACEs in their lifetime, increasing to 33% of females.

16,415 youth reported they felt so sad or hopeless almost every day for two weeks or more in a row that they stopped doing some usual activities.


The following graphs show Lucas County youth who had seriously considered attempting suicide and had attempted suicide in the past year. An example of how to interpret the information in the first graph includes: 17% of youth seriously considered attempting suicide in the past year, including 9% of males and 23% of females.

Note for graphs: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than

that of the overall survey.

17%

9%

23%

13%

18%

23%

12%

0%

5%

10%

15%

20%

25%

30%


Lucas County 6th-12th Grade Youth Who Had Seriously Considered Attempting Suicide in the Past Year

10%

6%

12%

6%

12%13%

7%

0%

5%

10%

15%

20%


Lucas County 6th-12th Grade Youth Who Attempted Suicide in the Past Year


The following graph shows Lucas County youth who felt sad or hopeless almost every day for two weeks or more in a row in the past year. An example of how to interpret the information includes: 38% of youth felt sad or hopeless almost every day for two weeks or more in a row, including 27% of males, and 47% of females.


The table below indicates correlations between those who contemplated suicide in the past year and participating in risky behaviors, as well as other activities and experiences. An example of how to interpret the information includes: 70% of those who contemplated suicide had been bullied in the past year, compared to 26% of those who did not contemplate suicide.

Behaviors of Lucas County Youth Contemplated Suicide vs. Did Not Contemplate Suicide

“Contemplated suicide” indicates youth who self-reported seriously considering attempting suicide in the past year. Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the

overall survey.

Youth Behaviors Contemplated

Suicide

Did Not Contemplate

Suicide



60% 18%

Had sexual intercourse in their lifetime 34% 16%



Smoked cigarettes (in the past month) 7% 2%

38%

27%

47%

27%

43%47%

24%

0%

10%

20%

30%

40%

50%

60%


Lucas County 6th-12th Grade Youth Who Felt Sad or Hopeless Almost Every Day For Two or More Weeks in a Row in the Past Year


The following graph shows the percentage of Lucas County youth who had experienced three or more adverse child experiences (ACEs) in their lifetime. An example of how to interpret the information includes: 25% of all Lucas County youth had experienced three or more ACEs in their l ifetime, including 33% of females and 35% of those 17 and older.


The table below indicates correlations between those who experienced three or more ACEs, as well as other activities and experiences. An example of how to interpret the information includes: 67% of those who experienced three or more ACEs in their lifetime felt sad or hopeless almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past year, compared to 21% of those who did not experience any ACEs.

Behaviors of Lucas County Youth Experienced three or More ACEs vs. Did Not Experience Any ACEs

Youth Behaviors Experienced

Three or More ACEs



67% 21%




Have had at least one drink of alcohol (in the past month) 25% 7%


Have used marijuana (in the past month) 23% 6%

Misused medications (in their lifetime) 14% 3%

Smoked cigarettes (in the past month) 5% 2%

25%

14%

33%

17%

28%

35%

19%

0%

10%

20%

30%

40%

Lucas 2019 Male Female 13 or younger 14 to 16 17 & Older Lucas '16-17

Lucas County 6th-12th Grade Youth Who Experienced Three or More ACEs in Their Lifetime


Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)

Lucas County

2013/14 (9th-12th)


Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S 2019

(9th-12th)


17% 16% 18% 14% 19% 16% 19%

Attempted suicide (in past year) 10% 4% 8% 8% 11% 7% 9%

Felt sad or hopeless (almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past 12 months)

38% 24% 29% 29% 45% 33% 37%

Youth Depression: Signs and Symptoms

• Occasionally being sad or feeling hopeless is a part of every child’s life. However, some children feel sad or uninterested in things that they used to enjoy or feel helpless or hopeless in situations where they could do something to address the situations. When children feel persistent sadness and hopelessness, they may be diagnosed with depression.

• Examples of behaviors often seen when children are depressed include — Feeling sad, hopeless, or irritable a lot of the time — Not wanting to do or enjoy doing fun things — Changes in eating patterns – eating a lot more or a lot less than usual — Changes in sleep patterns – sleeping a lot more or a lot less than normal — Changes in energy – being tired and sluggish or tense and restless a lot of the time — Having a hard time paying attention — Feeling worthless, useless, or guilty — Self-injury and self-destructive behavior

• Extreme depression can lead a child to think about suicide or plan for suicide. For youth ages 10-24 years,

suicide is the leading form of death.

• Some children may not talk about helpless and hopeless thoughts, and they may not appear sad. Depression might also cause a child to make trouble or act unmotivated, so others might not notice that the child is depressed or may incorrectly label the child as a trouble-maker or lazy.

(Source: CDC, Children’s Mental Health: Anxiety and Depression, March 20, 2020)

YOUTH SOCIAL DETERMINANTS OF HEALTH | 284

Youth Health: Social Determinants of Health Key Findings Seventy percent (70%) of Lucas County youth had been to the dentist in the past year. Twelve percent (12%) of youth drivers had texted while driving in the past month. Forty-five percent (45%) of youth who had a social media or online gaming account believed that sharing information online is dangerous.

Personal Health • Youth last saw a dentist for a check-up, exam, teeth cleaning, or other dental work at the following

frequencies: less than a year ago (70%), one to two years ago (11%), more than two years ago (4%), never (2%), and do not know (13%).

• Lucas County youth had been told by a doctor or nurse that had ever had asthma (21%), high blood pressure (5%), and diabetes (<1%).

• Lucas County youth reported they got the following amounts of sleep on an average school night: four hours or less (7%), five hours (12%), six hours (22%), seven hours (23%), eight hours (21%), nine hours (11%) and ten hours or more (4%).

• During the past year, youth felt their experience with health care workers was better than people of other races (3%), worse than people of other races (2%), worse than people of some races, better than others (2%), and only encountered people of the same race (1%). Three percent (3%) of youth did not get health care in the past year.


Personal Safety • Eighty-nine percent (89%) of Lucas County youth had a social media or online gaming account. Of those who

had an account, they reported the following: They knew all the people in their “friends” (35%) Their account was currently checked private (34%) They knew all of the people they play online (26%) Their parents had their password (19%) Their friends had their passwords to some or all of their accounts (11%) They had been asked to meet someone they met online (8%) They were bullied because of their accounts (4%) They share personal information such as where they live (4%) Their parents do not know they have an account (3%) They had participated in sexual activity with someone they met online (3%)

Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Visited a dentist within the past year (for a check-up, exam, teeth cleaning, or other dental work)

70% 79% 77% 76% 68% 78% 76%

Diagnosed with asthma 21% N/A N/A 24% 24% 24% 22%


• Forty-five percent (45%) of youth who had a social media or online gaming account believed that sharing information online is dangerous.

• Lucas County youth reported being unsupervised on an average school day: less than one hour (19%), one to two hours (25%), three to four hours (15%), more than four hours (13%), and overnight (6%). Twenty-two percent (22%) of youth reported they spent no time unsupervised on an average school day.

• More than two-fifths (41%) of youth hit their head hard enough that they were dizzy, had a concussion, were knocked out, or had their “bell rung” in their lifetime, increasing to 47% of males.

• In the past month, youth drivers did the following while driving: wore a seatbelt (57%), ate (27%), talked on their cell phone (17%), drove while tired or fatigued (15%), used their cell phone other than for talking or texting (13%), texted (12%), read (2%), used marijuana (1%), applied makeup (1%), used illegal drugs (1%), and drank alcohol (1%).

Education

• Lucas County youth reported the following plans for their future: attend a four-year college (63%), follow their career path/seek employment (56%), attend a community college or technical/trade school (23%), and join the military (9%). Five percent (5%) of youth reported no hope for their future. One percent (1%) of youth will not finish high school.

• Youth reported the following regarding school: they get bored at school (67%), their teachers care about them (60%), their teachers push them to do their best (59%), they get a lot of encouragement (43%), they feel protected at school (38%), adults do not take bullying seriously at school (16%), they skipped school in the past month (12%), they do not go to class unprepared (11%), teachers and/or staff do not care about them (9%), and teachers and/or staff bully them (6%).

Neighborhood and Built Environment • Youth reported living with both parents (45%), mother only (25%), mother and step-parent (12%), grandparents

(8%), father only (7%), joint custody parents (6%), another relative (5%), father and step-parent (4%), mother and her partner (3%), on their own or with friends (1%), father and his partner (1%), and guardians/foster parents (1%).

• Youth reported the following issues in their household: temperature regulation (e.g., too hot/too cold) (6%), insects (4%), plumbing problems (4%), odors (4%), rodents (2%), mold (2%), and bed bugs/lice (1%).

• During the past year, youth reported an adult discussed the following topics with them: — Goals for the future (73%) — Respecting themselves (50%) — Dating and healthy relationships (48%) — Healthy ways to deal with stress and depression (44%) — Condoms/safer sex/STD prevention (30%) — Body image (26%) — Abstinence and how to refuse sex (22%) — Birth control options (20%) — None of the above topics (19%)


Social and Community Context • Ten percent (10%) of youth reported gambling in their lifetime. Youth gamblers experienced the following:

gambled with larger amounts of money to get the same excitement (15%), gambled while drunk or high (11%), lied to a family member or others to hide their gambling (8%), and someone expressed concern about their gambling habits (6%). Sixty-five percent (65%) of youth did not experience any gambling issues.

• In the past month, youth reported feeling emotionally upset (e.g., angry, sad, or frustrated) based on how they were treated due to their skin color (7%), sexual orientation (5%), ethnicity (4%), gender identity (4%), culture (3%), religion (2%), and disability (2%).

• Eighty-two percent (82%) of youth participated in extracurricular activities. They participated in the following: — A sports or intramural program (50%) — School club or social organization (38%) — Exercising outside of school (36%) — Caring for siblings after school (27%) — Part-time job (24%) — Babysitting for other kids (19%) — Volunteering in the community (15%) — Church youth group (13%) — Church or religious organization (11%) — Caring for parents or grandparents (4%) — Some other organized activity (scouts, 4-H, etc.) (4%)

YOUTH VIOLENCE | 287

Youth Health: Violence Key Findings Two percent (2%) of Lucas County youth carried a weapon (such as a gun, knife or club) on school property in the past month. Thirty percent (30%) of youth had been involved in a physical fight in the past year. One-third (33%) of youth had been bullied in the past year.

Violence-Related Behaviors • Two percent (2%) of Lucas County youth carried a weapon on school property (such as a gun, knife or club) in

the past month. • Eight percent (8%) of youth were threatened or injured with a weapon on school property in the past year. • Youth did not go to school during the past month for the following reasons: felt unsafe at school (8%) and felt

unsafe on the way to or from school (3%). Physical and Sexual Violence • In the past year, 30% of youth had been involved in a physical fight, increasing to 34% of males.

• Of those who had been in a physical fight, 50% had been in a fight on more than one occasion.

• In the past year, 9% of youth reported an adult or caregiver hit, slapped, or physically hurt them on purpose.

• In the past year, youth reported someone they were dating or going out with did the following: forced or

pressured them to do sexual things that they did not want to (6%), physically hurt them on purpose (4%), and stalked them (4%).

• Lucas County youth had been forced to engage in the following: touched in an unsafe (sexual) way (6%), other sexual activity (2%), sexual intercourse (1%), and oral sex (1%).

• Thirty-five percent (35%) of youth purposefully hurt themselves in their lifetime by cutting, scratching, burning,

hitting or biting, increasing to 40% of females. Bullying • One-third (33%) of Lucas County youth had been bullied in the past year. The following types of bullying were

reported: 23% were verbally bullied (teased, taunted or called harmful names) 19% were indirectly bullied (spread mean rumors about them or kept them out of a “group”) 9% were cyber bullied (teased, taunted or threatened by e-mail or cell phone) 7% were physically bullied (were hit, kicked, punched or people took their belongings) 2% were sexually bullied (used nude or semi-nude pictures to pressure someone to have sex that did not

want to, blackmail, intimidate, or exploit another person) • In the past year, 20% of youth had been bullied on school property.

• In the past year, youth reported they had been a victim of teasing or name calling due to the following: weight,

size or physical appearance (24%); sexual orientation (10%); race or ethnic background (6%); religious affiliation (2%); gender (2%); and disability (1%).

12,959 Lucas County youth had been bullied in the past year.


The following graph shows Lucas County youth who were threatened or injured with a weapon on school property in the past year. Examples of how to interpret the information shown on the graph include: 8% of all youth had been threatened or injured with a weapon on school property in the past year, including 6% of males and 9% of females.


Types of Bullying Lucas County Youth Experienced in Past Year

Youth Behaviors Total Males Females 13 and

younger 14-16

Years old 17 and older

Verbally Bullied 23% 17% 28% 23% 25% 20%

Indirectly Bullied 19% 10% 28% 17% 20% 24%

Cyber Bullied 9% 4% 12% 7% 10% 11%

Physically Bullied 7% 8% 5% 8% 8% 3%

Sexually Bullied 2% 1% 3% 1% 3% 1%

8%

6%

9% 9%

7%8%

6%

0%

5%

10%

15%


Lucas County 6th-12th Grade Youth Threatened or Injured with a Weapon on School Property During the Past Year


Healthy People 2020 Injury and Violence Prevention (IVP)

Objective Lucas

County 2019

U.S. 2017


IVP-34 Fighting among adolescents

30% (6-12 Grade)

26%

(9-12 Grade)

23% (9-12 Grade)

28% (9-12 Grade)

IVP-35 Reduce bullying among adolescents on school property

20% (6-12 Grade)

17%

(9-12 Grade)

19% (9-12 Grade)

20% (9-12 Grade)

Note: The Healthy People 2020 target is for youth in grades 9-12. (Sources: Healthy People 2020 Objectives, 2017 U.S. YRBS, 2019/2020 Lucas County Health Assessment)

The table below indicates correlations between those who were bullied in the past year and participating in risky behaviors, as well as other activities and experiences. An example of how to interpret the information includes: 58% of those who were bullied felt sad or hopeless almost every day for two or more weeks in a row so that they stopped doing some usual activities in the past year, compared to 28% of those who were not bullied.

Behaviors of Lucas County Youth Bullied vs. Non-Bullied

Youth Behavior Bullied Non-Bullied



58% 28%


44% 15%


Classified as overweight or obese by body mass index (BMI) 33% 29%






Carried a weapon on school property (in the past month) 4% 1%

Smoked cigarettes (in the past month) 4% 2% Note: Caution should be used when interpreting subgroup results as the margin of error for any subgroup is higher than that of the overall survey.


Youth Comparisons

Lucas County 2019

(6th-12th)

Lucas County 2011

(9th-12th)



Lucas County 2019

(9th-12th)

Ohio 2019

(9th-12th)

U.S. 2019

(9th-12th)

Were in a physical fight (in past year)

30% 28% 25% 23% 26% 19% 22%


2% N/A 9% N/A 2% N/A 3%


8% N/A 7% 7% 8% N/A 7%

Did not go to school because they felt unsafe (at school or on their way to or from school in the past 30 days)

11% 6% 6% 4% 17% N/A 9%

Electronically bullied (in past year)

9% 15% 12% 12% 11% 13% 16%

Bullied (in past year) 33% 43% 38% 35% 33% N/A N/A


20% N/A 22% 17% 17% 14% 20%

Ever purposefully hurt themselves

35% 23% 10% N/A 31% N/A N/A


CHILD HEALTH AND FUNCTIONAL STATUS | 291

Child Health: Health and Functional Status Key Findings In 2020, 16% of children were classified as obese by body mass index (BMI) calculations. More than four-fifths (82%) of Lucas County parents had taken their child to the dentist in the past year. Ten percent (10%) of Lucas County parents reported their child had been diagnosed with asthma. Fourteen percent (14%) of parents reported their child had been diagnosed with ADD/ADHD. General Health Status of Children Ages 0-11 • In 2020, 97% of Lucas County parents rated their child’s health as excellent or very good. Three percent (3%) of

parents rated their child’s health as fair, and no parents (0%) rated their child’s health as poor. Health Conditions of Children Ages 0-11 • A doctor, health professional, or health educator told Lucas County parents their child had the following

conditions: — ADD/ADHD (14%) — Speech and language delay (14%) — Anxiety problems (11%) — Asthma (10%) — Behavioral/conduct problems (7%) — Depression (5%) — Learning disability (5%) — Obsessive-compulsive disorder (OCD) (3%) — Autism/autism spectrum disorder (ASD) (3%)

— Cerebral palsy (2%) — Fetal alcohol syndrome (2%) — Diabetes (1%) — Overweight/obese (1%) — Genetic or inherited condition (1%) — Intellectual disability/mental retardation (1%) — Epilepsy/seizure disorder (<1%) — Neonatal abstinence syndrome (<1%)

• Thirty-eight percent (38%) of Lucas County parents reported their child had at least one health condition. • Seven percent (7%) of parents reported their child ages 0-11 had an episode of asthma or had an asthma attack

in the past year, increasing to 12% of those with incomes less than $25,000. • Of parents who reported their child ages 0-11 had been diagnosed with autism/ASD or developmental delay,

29% reported their child has received therapy services to meet his/her developmental needs, such as early intervention, occupational therapy, or behavioral therapy.

• Parents reported their child had the following allergies: environmental allergies (16%), animal allergies (7%),

milk (5%), other food allergies (3%), eggs (2%), soy (1%), peanuts (1%), red dye (1%), wheat (<1%), and other allergies (4%). Of those with allergies, 2% had an EpiPen.

• More than two-fifths (41%) of parents reported their child had been tested for lead poisoning, and the results

were within normal limits. Less than one percent (<1%) reported the levels were elevated, and medical follow-up was needed. Nearly half (46%) of parents had not had their child tested for lead poisoning, and 14% of parents did not know if their child had been tested for lead.

2017/18 National Survey of Children’s Health

• Four percent (4%) of Ohio children ages 0-5 were diagnosed with asthma, increasing to 13% of 6-11 year olds.

• Fourteen percent (14%) of Ohio children ages 6-11 were diagnosed with ADD/ADHD.

(Source: National Survey of Children’s Health, 2017/18)


Asthma The following graph shows the percentage of children who were diagnosed with asthma in Lucas County, Ohio, and the U.S. • Lucas County had a higher percentage of children ages 6-11 who were diagnosed with asthma compared to

both Ohio and the U.S.

(Sources: National Survey of Children’s Health & 2020 Lucas County Health Assessment)

Weight Status and Nutrition of Children Ages 0-11 • Sixteen percent (16%) of children were classified as obese by (BMI) calculations. Nine percent (9%) of children

were classified as overweight, 62% were normal weight, and 13% were underweight.

• On an average day of the week, Lucas County parents reported their child spent 1.7 hours watching TV, 1.4 hours reading, 0.8 hours playing video games, 0.6 hours on a cell phone, and 0.6 hours on a PC/tablet.

• Thirty percent (30%) of Lucas County children ate 5 or more servings of fruits and/or vegetables per day, 47% of

children ate 3-4 servings, and 22% of children ate 1-2 servings. One percent (1%) of children ate 0 servings of fruits and/or vegetables per day.

The table below indicates the number of servings Lucas County children had of fruit, vegetables, sugar-sweetened beverages and caffeinated beverages per day.

5 or more servings

3-4 servings 1-2 servings 0 servings

Fruits 2% 28% 68% 2%




4%

14%

4%

13%

6%

13%

0%

5%

10%

15%

20%

Ages 0-5 Ages 6-11

Lucas County Children Diagnosed with Asthma

Lucas County 2020 Ohio 2017/18 U.S. 2017/18


Oral Health of Children Ages 0-11 • Eighty-two percent (82%) of parents reported their child had been to the dentist in the past year, decreasing to

67% of those with incomes less than $25,000. • Parents indicated their child did not get all the dental care they needed for the following reasons: child was not

old enough to go/dentist would not see child yet because of their age (9%), costs too much (4%), treatment is ongoing (3%), no insurance (1%), dissatisfaction with Medicaid dentist (1%), could not find a dentist who accepted child’s insurance (1%), not available in area/transportation problems (1%), inconvenient times/could not get an appointment (1%), did not know where to go for treatment (<1%), dissatisfaction with staff (<1%), child refuses to go (<1%), missed an appointment and not allowed to go back to clinic (<1%), and other reasons (3%).

Child 0-5 Comparisons




Ohio 2017/18

Ages 0-5

U.S. 2017/18

Ages 0-5

Rated health as excellent or very good 91% 98% 99% 92% 93%

Dental care visit (in past year) 64% 61% 64% 52%** 62%**

Diagnosed with asthma 11% 5% 4% 4% 6%

Diagnosed with ADHD/ADD 1% 0% 1% 1%* 2%*


3% 0% 4% 3%* 5%*

Diagnosed with depression 1% 0% 4% 0%* <1%*

Diagnosed with epilepsy 0% 0% 0% N/A 1%

Diagnosed with a head injury 1% 0% 0% N/A N/A

Diagnosed with anxiety problems 2% 0% 3% 1%* 2%*

Diagnosed with developmental delay N/A 3% 0% 10%* 8%*

Diagnosed with learning disability 3% 0% 0% 1%* 2%*


15% 10% 10% 6%* 11%*

Two or more health conditions N/A N/A 6% 5% 7% N/A – Not available **Ages 1-5 *Ages 3-5






Ohio 2017/18

Ages 6-11

U.S. 2017/18

Ages 6-11

Rated health as excellent or very good 86% 97% 95% 89% 90%

Dental care visit (in past year) 91% 94% 92% 93% 92%

Diagnosed with asthma 17% 15% 14% 13% 13%

Diagnosed with ADHD/ADD 14% 12% 22% 14% 10%


5% 9% 9% 13% 10%

Diagnosed with depression 2% 2% 6% 1% 2%

Diagnosed with epilepsy 2% 1% 1% N/A 1%

Diagnosed with a head injury 2% 1% 0% N/A N/A

Diagnosed with anxiety problems 6% 10% 15% 9% 9%

Diagnosed with developmental delay N/A 10% 0% 8% 8%

Diagnosed with learning disability 5% 6% 8% 11% 9%


9% 11% 16% 10% 10%

Two or more health conditions N/A N/A 22% 23% 21% N/A – Not Available

Children’s Mental Health

• What are mental health disorders? — Mental health disorders among children are described as serious changes in the way children usually learn

behave, or handle their emotions, which cause distress and problems getting through the day.

• What are the symptoms of mental disorders? — Symptoms may change over time as a child grows and may include difficulties with the way children play, learn,

speak, and act or how the child handles their emotions. Diagnosis often occurs in the school years, however, some children with a disorder may not be recognized or diagnosed as having one.

• How are mental health disorders treated? — Childhood mental health disorders can be treated and managed. There are many treatment options based on the

most current medical evidence and doctors should work closely with everyone involved in the child’s treatment (teachers, coaches, therapists, family members, etc.)

— Early diagnosis and appropriate treatment can make a huge difference in the lives of children with mental health disorders.

(Source: Centers for Disease Control and Prevention, Children’s Mental Health, Updated March 30, 2020)

CHILD HEALTH CARE ACCESS | 295

Child Health: Health Care Access Key Findings In 2020, 1% of Lucas County parents reported their child did not currently have health insurance. Thirteen percent (13%) of parents reported their child did not get all of the prescription medications they needed in the past year. Ninety-six percent (96%) of parents had taken their child to the doctor for preventive care in the past year. Health Insurance of Children Ages 0-11 • One percent (1%) of parents reported their child did not

currently have health insurance. • Lucas County parents reported their child was covered by the following types of health insurance: parent’s

employer (80%); Medicaid, Buckeye, Paramount, Molina, United, Care Source, or State Children’s Health Insurance Program (S-CHIP) (18%); purchased directly from an insurance company (2%); Insurance Marketplace (1%); TRICARE or other military health care (1%); Medicare (1%); and some other source of insurance (<1%).

• Parents reported their child’s health insurance covered the following: doctor visits (99%); well visits (98%);

immunizations (98%); prescription coverage (97%); hospital stays (96%); dental (93%); vision (86%); mental health (83%); and therapies (speech, occupational therapy, physical therapy, etc.) (77%).

• Twelve percent (12%) of Lucas County families had problems paying for their child’s medical or health care bills within the past year.

The following pie chart shows the sources of Lucas County children’s health care coverage.


• Thirty-two percent (32%) of Ohio 0-5-year-olds and 25% of Ohio 6-11-year-olds had public insurance.

• Seventy-two percent (72%) of Ohio 0-5-year-olds and 77% of Ohio 6-11-year-olds had a personal doctor or nurse.


Current/Former Employer or Union

80%

Medicare1%

Medicaid, OHP, or State Children's Health Insurance Program (S-CHIP)

18%

Self-paid plan2%

TriCare or other military health care

1%

Some other source of insurance

<1%

Source of Health Coverage for Lucas County Children


Medical Home of Children Ages 0-11 • Eighty-four percent (84%) of parents reported they had one or more people they think of as their child’s

personal doctor or nurse, decreasing to 70% of those with incomes less than $25,000. • Ninety-six percent (96%) of parents reported their child had visited their health care provider for preventive

care in the past year, increasing to 100% of 0-5 year olds.

• Lucas County parents reported that their child went to the following places when they were sick or needed advice about their health: a private doctor’s office (85%); multiple places, including a doctor’s office (6%); an urgent care center (5%); hospital emergency room (2%); a community health center (1%); mental health provider (<1%); in store health clinic (<1%); and family and friends (<1%).

Types of Specialists (% of all parents who looked for a specialist)

Lucas County parents who looked, but were unable to find a specialist for their child

Lucas County parents who looked and went to a specialist for their child

Neurologist (29% of all parents looked)

1% 99%

Dermatologist (skin) doctor (24% of all parents looked)

1% 99%

Ear, nose and throat doctor (15% of all parents looked)

2% 98%

Pulmonologist (lung) doctor (10% of all parents looked)

7% 93%

Ophthalmologist (eye) doctor (10% of all parents looked)

11% 89%

Oncologist/cancer doctor (9% of all parents looked)

8% 92%

Allergist (8% of all parents looked)

0% 100%

Psychiatrist/mental health provider (5% of all parents looked)

13% 87%

Heart doctor (5% of all parents looked)

8% 92%

Other specialist (4% of all parents looked)

17% 83%

Endocrinologist (1% of all parents looked)

0% 100%

Developmental pediatrician (1% of all parents looked)

0% 100%


Access and Utilization of Children Ages 0-11 • Eleven percent (11%) of parents reported the following prevented their child from getting all of the medical

care they needed in the past year: cost too much (31%), treatment is ongoing (16%), too long of a wait for an appointment (13%), no convenient times/could not get appointment (13%), no insurance (13%), dissatisfaction with doctor (6%), missed an appointment and not allowed to go back to the clinic (6%), unreliable/lack of child care (6%), not available in area/transportation problems (6%), no referral (6%), did not know where to go for treatment (3%), health plan problem (3%), doctor did not know how to treat or provide care (3%), dissatisfaction with office staff (3%), and could not find a doctor who accepted child’s insurance (3%). Eighty-nine percent (89%) of Lucas County parents reported their child received all the medical care they needed in the past year.

• Thirteen percent (13%) of parents reported the following prevented their child from getting all their

prescription medications filled in the past year: costs too much (11%), not available in area/transportation problems (5%), treatment is ongoing (5%), did not think their child needed it (3%), health plan problem (3%), no insurance (3%), did not know where to go to fill prescriptions (3%), and other reasons (11%). Eighty-seven percent (87%) of parents reported their child received all of their prescription medications in the past year.

• Fifty-five percent (55%) of parents reported the following prevented their child from getting all of the mental

health care they needed in the past year: cost too much (6%), no convenient times/could not get appointment (3%), too long of a wait for an appointment (3%), could not find a doctor who accepted child’s insurance (2%), not available in area/transportation problems (1%), did not know where to go for treatment (1%), dissatisfaction with doctor/office staff (1%), no insurance (1%), missed appointment and not allowed back at clinic (1%), no referral (1%), and other reasons (2%). Forty-five percent (45%) of Lucas County parents reported their child received all the mental health care they needed in the past year.

• Parents reported their child needed the following special services in the past year:

— Counseling (11%) — Speech therapy (9%) — Psychiatry (5%) — Occupational therapy (4%) — Medical equipment (3%) — Early intervention/special education (3%) — Physical therapy (2%) — Home health nursing (<1%) — Other (5%)

• Over half (56%) of Lucas County parents reported their child ages 0-11 years old had received the flu vaccine in

the past year, decreasing to 33% of those with incomes less than $25,000.

• Ninety-three percent (93%) of parents reported their child had received all their recommended vaccinations.

• Parents reported their child did not get all their recommended vaccinations for the following reasons: — Child had received some, but not all recommended vaccinations (3%) — Parents chose not to vaccinate their child (1%) — Fear of negative effects (1%) — Alternate vaccination schedule used (1%) — Not sure which are recommended (1%) — Religious or cultural beliefs (1%) — Vaccine not available at doctor’s office (<1%) — Too expensive (<1%) — Other reasons (1%)






Ohio 2017/18

Ages 0-5

U.S. 2017/18

Ages 0-5

Had public insurance 28% 28% 17% 32% 33%

Been to doctor for preventive care (in the past year)

95% 96% 100% 92%¥ 89%¥

Received all the medical care they needed 93% 99% 94% N/A N/A

Had a personal doctor or nurse 56% 88% 84% 72% 72%


N/A N/A 15% 7% 9%

¥2016/17 NSCH data N/A – Not Available





Ohio 2017/18

Ages 6-11

U.S. 2017/18

Ages 6-11

Had public insurance 22% 26% 20% 25% 32%

Been to doctor for preventive care (in the past year)

88% 92% 93% 81%¥ 80%¥

Received all the medical care they needed 94% 96% 86% N/A N/A

Had a personal doctor or nurse 58% 85% 84% 77% 72%


N/A N/A 10% 10% 11%

¥2016/17 NSCH data N/A – Not Available


(Source: Centers for Disease Control and Prevention, Immunization Schedules, 2020)

EARLY CHILDHOOD (AGES 0-5) | 300

Child Health: Early Childhood (Ages 0-5) Key Findings The following information was reported by parents of 0-5 year olds. Ninety-four percent (94%) of mothers got prenatal care within the first three months during their last pregnancy. Sixteen percent (16%) of mothers received WIC services during their last pregnancy. Ninety percent (90%) of parents put their child to sleep on his/her back. Sixteen percent (16%) of mothers never breastfed their child. Early Childhood

• During their last pregnancy, mothers did the following:

— Took a multivitamin with folic acid during pregnancy (100%) — Received prenatal care within the first three months (94%) — Took a multivitamin with folic acid pre-pregnancy (80%) — Received a dental exam (62%) — Took folic acid during pregnancy (38%) — Experienced anxiety during or after pregnancy (31%) — Experienced depression during or after pregnancy (27%) — Took folic acid pre-pregnancy (24%) — Received WIC services (16%) — Smoked cigarettes or other tobacco products (4%) — Experienced domestic violence (2%) — Did not have reliable transportation during or after pregnancy (2%) — Used marijuana (2%) — Consumed alcoholic beverages (1%) — Received opiate replacement therapy (1%) — Used e-cigarettes/vapes (1%)

• Thinking back to their last pregnancy, 46% of women wanted to be pregnant then, 24% wanted to be pregnant

sooner, 7% did not want to be pregnant then or any time in the future, 11% wanted to be pregnant later, and 12% of women did not recall.

• Ninety-three percent (93%) of Lucas County mothers reported they attended their post-partum checkup within

three to eight weeks after delivery. Three percent (3%) of mothers reported they were not scheduled a three to eight-week post-partum checkup.

• One third (33%) of mothers had children less than 27 months apart. • When asked how parents put their child to sleep as an infant, 90% said on their back, 5% said on their stomach,

and 3% said on their side. Two percent (2%) of parents reported they did not know. • Lucas County parents reported putting their child to sleep in the following places:

— Crib/bassinette without bumper, blankets, or stuffed animals (77%) — Pack n’ play (55%) — Swing (30%) — In bed with another person (25%) — Car seat (19%) — Crib/bassinette with bumper, blankets, or stuffed animals (18%) — Floor (7%) — Couch or chair (4%)


• Lucas County parents reported their childcare decisions were influenced by the following: trust in staff (74%), location/environment (62%), cost (61%), number of kids to teacher ratio (50%), hours of operation (49%), if the childcare is licensed (43%), quality star ratings (40%), and if Early Head Start is available (5%). Fourteen percent (14%) of Lucas County parents reported none of the above, and 2% of parents reported having no preference when making childcare decisions.

• In the past month, parents reported their child regularly attended the following:

— Nursery school, pre-school or kindergarten (44%) — Childcare in their home provided by a relative other than a parent/guardian (41%) — Childcare outside of their home provided by a relative other than a parent/guardian (33%) — Childcare center (30%) — Family-based childcare outside of home (26%) — Childcare in their home provided by a babysitter (24%) — Elementary school (11%) — Head Start or Early Start program (3%)

• Mothers breastfed their child for the following amounts of time:

— Less than three months (24%) — Four to six months (15%) — Seven to nine months (8%) — 10 months to one year (14%) — More than one year (18%) — Still breastfeeding (6%) — Never breastfed (16%)

• Parents gave the following reasons why their child was not breastfed for one year:

— Did not produce enough milk (48%) — Did not want to (21%) — Inconvenient (13%) — Did not have time (12%) — Did not have workplace support (8%) — Medical issue with baby (7%%)

— Medical issues with self (5%) — Did not have adequate family support (4%) — Did not have adequate education (1%) — Other (21%) — No one reported they did not have a breast

pump or for cultural reasons


Breastfeeding The following graph shows the percent of infants who had been breastfed or given breast milk in Lucas County, Ohio, and U.S. • Lucas County had a higher percent of children who had been breastfed for any length of time, compared to

Ohio and the U.S.

(Sources: National Survey of Children’s Health & 2020 Lucas County Health Assessment)



Years


Years


Years

Ohio 2017/18

Ages 0-5

Years

U.S. 2017/18

Ages 0-5

Years

Never breastfed their child 29% 22% 16% 20% 20%

Child put to bed on their back 68% 81% 90% N/A N/A N/A – Not Available

80%

80%

84%

20%

20%

16%

0% 20% 40% 60% 80% 100%

U.S. 2017/18

Ohio 2017/18

Lucas County 2020

Lucas County Children Breastfed

Never Breastfed Breastfed


Sleep-Related Infant Death Factors The following charts show the percentage of Ohio infant deaths by location when the infant was found and the age of infant at time of death. • More than two-fifths (43%) of the sleep-related infant deaths in Ohio were found in an adult bed. • Nearly three-fifths (58%) of the sleep-related deaths involved infants between one month and three months

old.

(Source: ODH, Ohio Child Fatality Review, Seventeen Annual Report)

Adult Bed, 43%

Crib, 17%

Couch, 14%

Other, 14%

Bassinet, 8%Unknown, 4%

Reviews of Ohio Sleep-Related Infant Deaths by Incident Location, 2012-2016 (n=714)

91

135153

127

6449 43

15 218 6 2

0

50

100

150

200

<1 1 2 3 4 5 6 7 8 9 10 11

Nu

mb

er o

f D

eath

s

Age in Months

Ohio Sleep-Related Infant Deaths by Age in Months, 2012-2016 (n=714)

MIDDLE CHILDHOOD (AGES 6-11) | 304

Child Health: Middle Childhood (Ages 6-11) Key Findings The following information was reported by Lucas County parents of 6-11 year olds. Ninety-two percent (92%) of parents reported their child participated in extracurricular activities. More than three-fourths (77%) of parents reported their child was physically active for at least 60 minutes on three or more days per week. Middle Childhood • Lucas County children were enrolled in the following types of schools: public (71%), private (12%), and home-

schooled (6%). No parent reported that their child was not enrolled in school. • Ninety-two percent (92%) of parents reported their child participated in extracurricular activities in the past

year. They participated in the following: a sports team or sports lessons after school or on weekends (74%); a club or organization after school or on weekends (53%); any other organized activities or lessons, such as music, dance, language, or other arts (48%); any type of community service or volunteer work at school, church, or in the community (37%); and any paid work including regular jobs as well as babysitting, cutting grass, or other occasional work (13%). Eight percent (8%) of parents reported their child did not participate in any extracurricular activities in the past year.

• More than one-fourth (27%) of parents reported their child had a social media or other virtual network account.

Of those who had an account, they reported the following: — They had their child’s password (78%) — They knew all of the people in their child’s “my friends” (71%) — Their child’s account was checked private (57%) — Their child had a problem as a result of their account (4%)

• More than three-fourths (77%) of parents reported their child was physically active for at least 60 minutes on

three or more days per week. Nearly half (46%) were physically active on five or more days, and 13% were physically active for at least 60 minutes every day per week. Three percent (3%) reported not engaging in any physical activity in the past week.

• Over half (55%) of Lucas County parents reported they would vaccinate their child for the human papilloma

virus (HPV). Six percent (6%) reported their child had already been vaccinated for HPV, and 34% said they are unsure if the HPV vaccine is safe. Five percent (5%) reported their child is not going to have sex.

• Thirty-four percent (34%) of parents believed that teaching the reproductive system should be taught in grades

3-5. Fifty percent (50%) believed it should be taught in grades 6-8, 8% believed in grades K-2, and 9% believed it should be taught in grades 9-12.

• Fifty-nine percent (59%) of parents believed that abstinence and refusal skills should be taught in grades 6-8.

Seventeen percent (17%) believed it should be taught in grades 3-5, 11% believed in grades K-2, and 12% believed it should be taught in grades 9-12. One percent (1%) of parents thought this should not be taught at all.

• Half (50%) of parents thought that birth control and the use of condoms should be taught in grades 6-8. Forty-

two percent (42%) believed it should be taught in grades 9-12, and 4% believed it should be taught in grades 3-5. Four percent (4%) of parents thought this should not be taught at all.

MIDDLE CHILDHOOD (AGES 6-11) | 305

• Lucas County parents reported their child read outside of school at the following frequencies: — Almost never, child cannot read (1%) — Almost never, child has no interest (5%) — A few times a year (3%) — A few times a month (10%) — A few times a week (22%) — Almost every day (59%)

• Parents discussed the following topics with their 6-11 year old child in the past year: screen time (86%),

bullying/violence (84%), eating habits (82%), cyber/Internet safety (66%), body image (61%), cultural sensitivity (53%), firearm/gun safety (47%), negative effects of tobacco (46%), respect for gender identity/sexual orientation (41%), negative effects of alcohol (38%), negative effects of marijuana and other drugs (35%), refusal skills (31%), negative effects of heroin/opiates (29%), dating 2\and positive relationships (20%), prescription drug misuse (19%), abstinence and how to refuse sex (15%), birth control (7%), and condoms/safe sex/STD prevention (6%). One percent (1%) of parents did not discuss any of these topics with their 6-11 year old child.


Lucas County 2014 Ages 6-11 Years



Ohio 2017/18

Ages 6-11 Years

U.S. 2017/18

Ages 6-11 Years

Child participated in one or more activities N/A N/A 92% 78% 78%


How to Help Increase Your School-Aged Child's Social Ability

• Consider the following as ways to foster your school-aged child's social abilities: — Set and provide appropriate limits, guidelines, and expectations and consistently enforce using

appropriate consequences. — Model appropriate behavior. — Offer compliments for your child being cooperative and for any personal achievements. — Help your child choose activities that are appropriate for your child's abilities. — Encourage your child to talk with you and be open with his or her feelings. — Encourage your child to read and read with your child. — Encourage your child to get involved with hobbies and other activities. — Encourage physical activity. — Encourage self-discipline; expect your child to follow rules that are set. — Teach your child to respect and listen to authority figures. — Encourage your child to talk about peer pressure and help set guidelines to deal with peer pressure. — Spend uninterrupted time together—giving full attention to your child. — Limit television, video, and computer time.

(Source: Stanford Children’s Health, The Growing Child: School Age [6 to 12 Years], 2019)

PARENT HEALT FAMILY AND COMMUNITY CHARACTERISTICS | 306

Child Health: Family and Community Characteristics Key Findings Five percent (5%) of parents reported someone in their household went to bed hungry at least one day per week because they did not have enough money for food. Sixty-five percent (65%) of parents reported their neighborhood was always safe for their child to go out and play. Seven percent (7%) of parents reported their child experienced two or more adverse childhood experiences (ACEs) in their lifetime. Family Functioning • Thirty-seven percent (37%) of parents reported that

every family member who lived in their household ate a meal together every day of the week, increasing to 51% of parents of 0-5 year olds. Families ate a meal together an average of 5.0 days per week.

• Lucas County families reported their primary language spoken in their home was English (99%), Spanish (<1%),

and Arabic (<1%). • Five percent (5%) of parents reported someone in their household went to bed hungry at least one day per

week because they did not have enough money for food, increasing to 12% of those with incomes less than $25,000.

• Parents reported their child got the following amounts of sleep on an average weeknight:

— Eight hours or less (24%) — Nine hours (26%) — Ten hours (30%) — Eleven hours or more (21%)

• Six percent (6%) of parents, increasing to 15% of those with incomes less than $25,000, reported that they or

someone in their family had to quit a job, not take a job, or greatly change their job because of the following problems concerning child care for their child: could not afford child care (5%), physical disability (1%), child was medically fragile (<1%), severe behaviors (<1%), and their child was removed from school (<1%).

• In the past year, parents reported that someone in the household received the following:

— Free or reduced cost breakfast or lunches at school (14%) — SNAP/food stamps (10%) — Mental health/substance abuse treatment (7%) — Benefits from WIC program (5%) — Help Me Grow (3%) — Cash assistance from a welfare program (2%) — Subsidized childcare through JFS (2%) — Head Start/Early Head Start (1%)

• Parents reported doing the following activities with their child outside of school within the past year: cleaning

the home or yard work (85%); walking, jogging, or running (79%); swimming (73%); sports (59%); biking (58%); dancing (45%); playing tag or jumping rope (43%); hiking (29%); and skateboarding or rollerblading (10%).


• Fifty-seven percent (57%) of Ohio and 54% of U.S. parents of 0-5 year olds reported their family ate a meal together every night of the week.

• Twenty-seven percent (27%) of Ohio and 20% of U.S. 6-11 year olds experienced two or more adverse childhood experiences (ACEs) in their lifetime.



Family Dinners The following graph shows the percent of Lucas County, Ohio, and U.S. families that ate a meal together every day of the week. • Thirty-seven percent (37%) of Lucas County families ate a meal together every day of the week.

(Source: National Survey of Children’s Health & 2020 Lucas County Health Assessment)

Five Ways That Family Meals Keep Kids Healthy

1. Family meals prevent excessive weight gain: Eating 3 or more family meals (meaning at least one parent is present and the meal is prepared at home) results in a 12% lower likelihood of children being overweight.

2. Family meals teach healthy food choices: The eating habits of childhood often last a lifetime. Families that ate

at least three meals together each had a 20% decrease in unhealthy food choices. Teaching your children to enjoy healthy foods rather than junk foods is a gift that will stay with them through adulthood.

3. Family meals prevent eating disorders: Children and adolescents who ate family meals at least three times per

week had a 35% reduction in disordered eating habits such as anorexia and bulimia. 4. Family dinner improves social-emotional health, too: The ability to understand emotions, express empathy,

demonstrate self-regulation, and form positive relationships with peers and adults is called social-emotional health. Young children with high social-emotional health adapt well to the school environment and perform well academically, even in long term studies. Guess which kids had the best social-emotional health? The ones who ate family dinner together regularly and talked about their day, told stories, etc.

5. Family dinner can help kids deal with cyberbullying: About one-fifth of adolescents are victims of

cyberbullying, putting them at risk for depression, substance abuse, and a host of other concerns. But adolescents who eat regular family dinners handle cyberbullying better and are less likely to engage in substance abuse or develop psychiatric health concerns, even after their involvement in face-to-face bullying is taken into account.

(Source: The Benefits & Tricks to Having a Family Dinner, HealthyChildren.org, December 30, 2015)

37%42% 44%

0%

20%

40%

60%Lucas County Families that Ate Together Everyday of the Week



Child Safety Characteristics Lucas County parents indicated that their child rode in a car seat, booster seat, or wore a seatbelt at the following frequencies:

Car Seat Booster Seat Seat Belt with No Booster Seat

Always (42%) Always (30%) Always (51%)

Nearly always (<1%) Nearly always (5%) Nearly always (4%)

Sometimes (1%) Sometimes (3%) Sometimes (2%)

Seldom (0%) Seldom (3%) Seldom (3%)

Never (5%) Never (19%) Never (7%)

Child is too big for car seat (52%)

Child is over 4’9” and 80 lbs. (23%) OR Child is too small for booster seat (19%)

Child is too small for seat belt with no booster seat (smaller than 4’9” and 80 lbs.) (35%)

• Forty-two percent (42%) of parents reported their child was bullied in the past year. The following types of

bullying were reported: — 18% were verbally bullied (teased, taunted or called harmful names) — 8% were physically bullied (they were hit, kicked, punched or people took their belongings) — 7% were indirectly bullied (spread mean rumors about them or kept out of a “group”) — 3% were cyber bullied (teased, taunted or threatened by e-mail or cell phone)

• Four percent (4%) of parents reported they did not know if their child was bullied. Neighborhood and Community Characteristics

• Lucas County parents reported their neighborhood was always safe (65%), usually safe (30%), sometimes safe

(4%), and never safe (1%) for their child to go out and play.

• Parents reported the following reasons they did not feel their neighborhood was safe: heavy traffic area (12%), no accessible sidewalks (10%), crime (9%), no place for kids to play (4%), loud/disrespectful noise levels (3%), bullying (2%), gangs (1%), and other (6%).

• Lucas County parents reported their child experienced the following adverse childhood experiences (ACEs) in

their lifetime: their parents became separated or were divorced (11%); lived with someone who was mentally ill, or suicidal, or severely depressed for more than a couple of weeks (6%); lived with someone who had a problem with alcohol or drugs (5%); lived with a parent/guardian who served time or was sentenced to serve time in prison or jail (3%); seen or heard any parents or adults in their home hit, beat, kicked, or physically hurt each other (3%); been the victim of violence or witness violence in their neighborhood (2%), lived with a parent/guardian who died (1%); and were treated or judged unfairly because his/her ethnic group (1%).

• Seven percent (7%) of parents reported their child experienced two or more ACEs in their lifetime, increasing to

23% of those with incomes less than $25,000.


The following graph shows the percent of Lucas County, Ohio, and U.S. children who experienced two or more ACEs. • Lucas County had a lower percent of children who experienced two or more ACEs as compared to Ohio and U.S

children.

(Source: National Survey of Children’s Health & 2020 Lucas County Health Assessment)

Home Environment Characteristics • Nine percent (9%) of Lucas County parents reported their child had moved to a new address three or more

times, increasing to 26% of those with incomes less than $25,000. Thirty percent (30%) moved one time, 11% moved two times, and 51% had never moved.

• Parents reported having the following safety items in their home: working smoke alarm/detector (98%), carbon

monoxide detector (76%), fire extinguisher (63%), and Poison Control number by the phone (36%). Ninety percent (90%) had more than one of these safety items in their home, and 2% had none of these safety items in their home.

• Thirty percent (30%) of parents reported they had a firearm in or around their home. No parent (0%) reported they were unlocked and loaded.

• Lucas County parents reported that someone in the household used cigarettes (7%), e-cigarettes/vapes (4%), cigars (1%), and/or other tobacco products (3%) around their child.

• Parents had the following rules about smoking tobacco products in their home and car: no one is allowed to

smoke inside the car at any time (86%); no one is allowed to smoke inside the home when children are present (39%); smoking is allowed, but only if children are not in the car (5%); smoking is allowed anywhere inside the home (2%); smoking is allowed, but only in certain rooms (2%); smoking is allowed, but only with one or more of the windows open in the car (2%), and smoking is allowed inside the car (1%).

• Parents had the following rules about using e-cigarette/vaping products in their home and car: no one is

allowed to smoke inside the car at any time (84%); no one is allowed to smoke inside the home when children are present (35%); smoking is allowed anywhere inside the home (4%); smoking is allowed inside the car (3%); smoking is allowed, but only if children are not in the car (2%); smoking is allowed, but only with one or more of the windows open in the car (1%), and smoking is allowed, but only in certain rooms (<1%).

1%

10%

18%

29%

12%

23%

0%

10%

20%

30%

40%

Ages 0-5 Ages 6-11

Lucas County Children Who Experienced Two or More ACEs





Years


Years


Years

Ohio 2017/18

Ages 0-5

Years

U.S. 2017/18

Ages 0-5

Years


50% 35% 51% 57% 54%

Neighborhood is usually or always safe 89% 90% 95% N/A N/A

Child experienced two or more ACEs N/A N/A 0% 13% 10%


N/A N/A 6% 10% 9%


N/A N/A 1% 5% 16%






Ohio 2017/18

Ages 6-11 Years

U.S. 2017/18

Ages 6-11 Years


39% 35% 29%

44%

45%

Neighborhood is usually or always safe 95% 91% 94% N/A N/A

Child experienced two or more ACEs N/A N/A 10% 27% 20%


N/A N/A 5% N/A N/A


N/A N/A 1% 5% 14%


PARENT PARENT HEALTH | 311

Child Health: Parent Health Key Findings In 2020, 61% of parents rated their health as excellent or very good, decreasing to 33% of parents with incomes less than $25,000. In the past year, 56% of parents missed work due to their child’s illnesses or injuries. Parent Health • Those filling out the survey had the following relationship to the child: mother (71%), father (26%), grandparent

(1%), and aunt/uncle (1%). • Fourteen (14%) of parents were uninsured.

• Sixty-one percent (61%) of parents rated their physical health as excellent or very good, decreasing to 33% of

parents with incomes less than $25,000. Eight percent (8%) of parents had rated their physical health as fair or poor.

• Sixty-five percent (65%) of mothers and 54% of fathers of 0 to 5 year olds rated their rated their physical health

as excellent or very good. Nine percent (9%) of mothers and 8% of fathers of 6 to 11 year olds rated their physical health as fair or poor.

• Sixty-four percent (64%) of parents rated their mental and emotional health as excellent or very good,

decreasing to 26% of parents with incomes less than $25,000. More than one-fourth (27%) rated their mental and emotional health as good, and 10% of parents rated their mental and emotional health as fair or poor.

• Seven percent (7%) of mothers and 7% of fathers of 0-5 year olds rated their mental and emotional health as

fair or poor. Thirteen percent (13%) of mothers and 6% of fathers of 6-11 year olds rated their mental or emotional health as fair or poor.

• Parents reported the following challenges they faced in regard to the day-to-day demands of parenthood/

raising children: — Demands of multiple children (44%) — Working long hours (20%) — Financial burdens (15%) — Being a single parent (11%) — Managing child’s behavior (11%) — Metal health (9%) — Loss of freedom (8%) — Child has special needs (7%) — Lack of parental support (4%)

— Difficulty with lifestyle changes (4%) — Affordable housing (3%) — Post-partum depression (3%) — Unemployment (2%) — Lack of transportation (1%) — Alcohol and/or drug abuse (1%) — Move a lot (<1%) — Domestic violence relationship (<1%)

• Thirty-seven (37%) of parents reported having more than one difficulty, increasing to 46% of parents with

incomes of less than $25,000.

• Parents did not apply for WIC for the following reasons: did not want to receive public assistance (7%), already enrolled in WIC (5%), food stamps are easier to get and use (1%), too much paperwork/renewal every six months (1%), inconvenient work schedule (<1%), and other reasons (3%). Five percent (5%) of Lucas County parents did not know if their child qualified for WIC services. Eighteen percent (18%) of parents reported their child did not qualify for WIC.

PARENT HEALTH | 312

• In the past year, 56% of parents reported they or someone in their household missed work due to their child’s illnesses or injuries. Forty-one percent (41%) missed work due to their child’s medical appointments, 6% missed work due to lack of or unreliable childcare, 4% missed work due to their child’s chronic illness, 4% missed work due to their child’s behavioral/emotional problems, and 1% missed work due to suspension/expulsion/sent home from school.

• During the past year, Lucas County parents felt their experience with health care was: — The same as people of other races/cultures/ethnicities (37%) — Better than people of other races/cultures/ethnicities (16%) — Only encountered people of the same race/culture/ethnicity (4%) — Worse than people of other races/cultures/ethnicities (2%) — Worse than some people of races, better than others (1%) — Worse than some people of races/cultures/ethnicities (<1%)

• Thirty-eight percent (38%) of adults did not know if their experience with health care was better or worse than

other races and 3% did not get health care in the past year.





Ohio 2017/18

Ages 0-5

U.S. 2017/18

Ages 0-5

Mother’s mental or emotional health is fair/poor

4% 10% 7% 9% 5%

Father’s mental or emotional health is fair/poor

2% 6% 7% 7% 3%

Mother’s physical health status is fair/poor 2% 6% 3% 3% 4%

Father’s physical health status is fair/poor 2% 6% 11% 3% 5%





Ohio 2017/18

Ages 6-11

U.S. 2017/18

Ages 6-11

Mother’s mental or emotional health is fair/poor

8% 9% 13% 9% 5%

Father’s mental or emotional health is fair/poor

1% 9% 6% 4% 3%

Mother’s physical health status is fair/poor 2% 6% 9% 7% 6%

Father’s physical health status is fair/poor 2% 6% 8% 7% 4%

APPENDIX I: HEALTH ASSESSMENT INFORMATION SOURCES | 313

Appendix I: Health Assessment Information Sources

Source Data Used Website

American Academy of Pediatrics • 5 Ways That Family Meals Keep Kids Healthy

https://www.healthychildren.org/English/health-issues/conditions/obesity/Pages/5-easy-ways-to-improve-your-familys-eating-habits.aspx

American Association of Suicidology • Suicide in the U.S.

https://suicidology.org/facts-and-statistics/

American Cancer Society

• 2020 Cancer Facts, Figures, and Estimates

https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2020.html

• 2019-2021 Cancer Facts and Figures for African Americans

https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-african-americans/cancer-facts-and-figures-for-african-americans-2019-2021.pdf

• Recommendations for Prostate Cancer Early Detection

https://www.cancer.org/cancer/prostate-cancer/detection-diagnosis-staging/acs-recommendations.html

• Summary of the ACS Guidelines on Nutrition and Physical Activity

https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html

American College of Allergy, Asthma & Immunology • Asthma Facts

http://acaai.org/news/facts-statistics/asthma

Behavioral Risk Factor Surveillance System, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Surveillance Branch, Centers for Disease Control

• 2017, 2018 Adult Ohio and U.S. Correlating Statistics

https://www.cdc.gov/brfss/index.html

Brady Campaign to Prevent Gun Violence • Victims of Gun Violence

https://www.bradyunited.org/fact-sheets

Centers for Disease Control and Prevention (CDC)

• Adverse Childhood Experiences (ACEs)

https://www.cdc.gov/violenceprevention/aces/fastfact.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Facestudy%2Ffastfact.html

• Arthritis: Key Public Health Messages

https://www.cdc.gov/arthritis/basics/management.htm

• Basic Facts about Mold and Dampness

https://www.cdc.gov/mold/faqs.htm

• Cancer Fast Facts https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm



Centers for Disease Control and Prevention (CDC)

• Children’s Mental Health https://www.cdc.gov/childrensmentalhealth/basics.html

• Disparities in Oral Health https://www.cdc.gov/oralhealth/oral_health_disparities/index.htm

• E-Cigarettes and Youth https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html

• Economic Costs of Excessive Alcohol Use

https://www.cdc.gov/features/costsofdrinking/index.html

• Facts About Adult Oral Health https://www.cdc.gov/oralhealth/basics/adult-oral-health/index.html

• Five Minutes for Women’s Health

https://www.cdc.gov/healthequity/features/fiveminutes/index.html

• Hispanic/Latinos and Tobacco Use

https://www.cdc.gov/tobacco/disparities/hispanics-latinos/index.htm

• Immunization Schedules https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf

• Men and Heart Disease https://www.cdc.gov/heartdisease/men.htm

• National Diabetes Statistics Report, 2020

https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

• Preventing Teen Drinking and Driving

https://www.cdc.gov/vitalsigns/mobile-test/index.html

• Prostate Cancer Screening https://www.cdc.gov/cancer/prostate/basic_info/screening.htm

• Reproductive Health: Unintended Pregnancy

https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/index.htm

• Sexual Risk Behavior https://www.cdc.gov/healthyyouth/sexualbehaviors/index.htm

• Smoking and Tobacco Use: About Electronic Cigarettes

https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html

• Smoking and Tobacco Use: Cost of Smoking

https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

• State Indicator on Fruits and Vegetables: Improving Fruit and Vegetable Access

https://www.cdc.gov/nutrition/downloads/fruits-vegetables/2018/2018-fruit-vegetable-report-508.pdf

• Youth Depression: Signs and Symptoms

https://www.cdc.gov/childrensmentalhealth/depression.html

• Youth Physical Activity Guidelines

https://www.cdc.gov/healthyschools/physicalactivity/guidelines.htm

CDC, Wonder, U.S.

• About Underlying Cause of Death, 2016-2018

• U.S. age-adjusted mortality rates

http://wonder.cdc.gov/ucd-icd10.html



Healthy People 2020: U.S. Department of Health & Human Services

• All Healthy People 2020 Target Data Points

• Some U.S. Baseline Statistics • Social Determinants of Health

www.healthypeople.gov/2020/topicsobjectives2020

Kaiser Family Foundation • Health and Health Care for Hispanics in the U.S.

https://www.kff.org/infographic/health-and-health-care-for-hispanics-in-the-united-states/

National Alliance on Mental Illness (NAMI)

• African American Mental Health https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/Black-African-American

• Common Signs of Mental Illness in Adults

https://www.nami.org/NAMI/media/NAMI-Media/Infographics/NAMI-Warning-Signs-FINAL.pdf

National Cancer Institute • Cancer Disparities among African American Women

https://www.cancer.gov/about-cancer/understanding/disparities

National Institute on Alcohol Abuse and Alcoholism

• Alcohol and the Hispanic Community

https://www.niaaa.nih.gov/sites/default/files/hispanicFact.pdf

National Survey of Children’s Health (NSCH)

• Ohio and U.S. 2017/2018 Correlating Statistics

https://www.childhealthdata.org/browse/survey

Ohio Automated Rx Reporting System (OARRS)

• Lucas County Number of Opiate and Pain Reliver Doses Per Capita and Per Patient

• Ohio Number of Opiate and Pain Reliver Doses Per Capita and Per Patient

https://www.ohiopmp.gov/



Ohio Department of Health

• 2018 Ohio Drug Overdose Data: General Findings

https://odh.ohio.gov/wps/wcm/connect/gov/d9ee6d3b-bf62-4b4f-8978-d7cfcd11348f/2018_OhioDrugOverdoseReport.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-d9ee6d3b-bf62-4b4f-8978-d7cfcd11348f-mXhFqNO

• Ohio Child Fatality Review, Seventeenth Annual Report

https://odh.ohio.gov/wps/wcm/connect/gov/cee74f65-5513-4641-be17-833915bc6dfb/2017+CFR+Report+-11-2-17.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-cee74f65-5513-4641-be17-833915bc6dfb-mtrJzwN

Ohio Department of Health, Information Warehouse

• Incidence of Cancer, 2013-2017 • Lucas County and Ohio Birth

Statistics • Lucas County and Ohio Leading

Causes of Death • Lucas County and Ohio

Mortality Statistics • Sexually Transmitted Diseases

www.odh.ohio.gov/

Ohio Department of Public Safety

• 2019 Lucas County and Ohio Crash Facts

• OSHP Computer-Aided Dispatch (CAD) System

https://ohiohighwaysafetyoffice.ohio.gov/otso-resources.aspx#gsc.tab=0

Ohio Development Services Agency • Ohio Poverty Report https://www.development.ohio.gov/files/research/P7005.pdf

Ohio State Highway Patrol

• Compliant Data • Electronic Crash Records • Felony Cases and Drug Arrests

• Lucas County Activity Statistics

http://statepatrol.ohio.gov/

Rape, Abuse, and Incest National Network (RAINN) • Scope of the Problem

https://www.rainn.org/statistics/scope-problem



Stanford Children’s Health • How to Increase Your School-Aged Child’s Social Ability

https://www.stanfordchildrens.org/en/topic/default?id=the-growing-child-school-age-6-to-12-years-90-P02278

Substance Abuse and Mental Health Services Administration (SAMHSA)

• Rise in Prescription Drug Misuse and Abuse Impacting Teens

https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/teen-prescription-drug-misuse-abuse

U.S. Department of Agriculture Food Environment Atlas, County Health Rankings

• Food Environment Index http://www.countyhealthrankings.org/

U. S. Department of Commerce, Census Bureau; Bureau of Economic Analysis

• American Community Survey 1-year estimates, 2019

• Federal Poverty Thresholds

• Ohio and Lucas County 2019 Census Demographic Information

• Ohio and U.S. Health Insurance Sources

• Small Area Income and Poverty Estimates

www.census.gov

U.S. Department of Health and Human Services, Office of Minority Health

• Cancer and Hispanic Women https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=61

• Chronic Liver Disease and Hispanic Americans

https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=62

• Hispanic/Latino Insurance Coverage

https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=64

Youth Risk Behavior Surveillance System, National Center for Chronic Disease Prevention and Health Promotion, Division of Adolescent and School Health, Centers for Disease Control

• 2017 youth Ohio and U.S. correlating statistics

https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

APPENDIX II: ACRONYMS AND TERMS | 318

Appendix II: Acronyms and Terms

AHS Access to Health Services, Topic of Healthy People 2020 objectives

Adult Defined as 19 years of age and older.

Age-Adjusted Death rate per 100,000 adjusted for the age Mortality Rates distribution of the population.

Adult Binge Drinking Consumption of five alcoholic beverages or more (for males) or four or more alcoholic beverages (for females) on one occasion.

AOCBC Arthritis, Osteoporosis, and Chronic Back Conditions

BMI Body Mass Index is defined as the contrasting measurement/relationship of weight to height.

BRFSS Behavior Risk Factor Surveillance System, an adult survey conducted by the CDC.

CDC Centers for Disease Control and Prevention.

Current Smoker Individual who has smoked at least 100 cigarettes in their lifetime and now smokes daily or on some days.

HCNO Hospital Council of Northwest Ohio

HDS Heart Disease and Stroke, Topic of Healthy People 2020 objectives

HP 2020 Healthy People 2020, a comprehensive set of health objectives published by the Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services.

HPIO Health Policy Institute of Ohio

Health Indicator A measure of the health of people in a community, such as cancer mortality rates, rates of obesity, or incidence of cigarette smoking.

High Blood Cholesterol 240 mg/dL and above

High Blood Pressure Systolic >140 and Diastolic > 90

IID Immunizations and Infectious Diseases, Topic of Healthy People 2020 objectives

N/A Data is not available.

NSCH National Survey of Children’s Health

ODH Ohio Department of Health

Race/Ethnicity Census 2010: U.S. Census data consider race and Hispanic origin separately. Census 2010 adhered to the standards of the Office of Management and Budget (OMB), which define Hispanic or Latino as “a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.” Data are presented as “Hispanic or Latino” and “Not Hispanic or Latino.” Census 2010 reported five race categories including: White, Black or African American, American Indian & Alaska Native, Asian, Native Hawaiian and Other Pacific Islander. Data reported, “White alone” or “Black alone”, means the respondents reported only one race.

SHA State Health Assessment

SHIP State Health Improvement Plan

Weapon Defined in the YRBS as “a weapon such as a gun, knife, or club”

Youth Defined as 12 through 18 years of age

YPLL/65 Years of Potential Life Lost before age 65. Indicator of premature death.

APPENDIX II: ACRONYMS AND TERMS | 319

Youth BMI Underweight is defined as BMI-for-age < 5th percentile Classifications Overweight is defined as BMI-for-age 85th percentile to < 95th percentile.

Obese is defined as > 95th percentile.

YRBS Youth Risk Behavior Survey, a youth survey conducted by the CDC

APPENDIX III: WEIGHTING METHODS | 320

Appendix III: Methods for Weighting the 2020 Lucas County Health Assessment Data

Data from sample surveys have the potential for bias if there are different rates of response for different segments of the population. In other words, some subgroups of the population may be more represented in the completed surveys than they are in the population from which those surveys are sampled. If a sample has 25% of its respondents being male and 75% being female, then the sample is biased towards the views of females (if females respond differently than males). This same phenomenon holds true for any possible characteristic that may alter how an individual responds to the survey items. In some cases, the procedures of the survey methods may purposefully over-sample a segment of the population in order to gain an appropriate number of responses from that subgroup for appropriate data analysis when investigating them separately (this is often done for minority groups). Whether the over-sampling is done inadvertently or purposefully, the data needs to be weighted so that the proportioned characteristics of the sample accurately reflect the proportioned characteristics of the population. In the 2020 Lucas County survey, a weighting was applied prior to the analysis that weighted the survey respondents to reflect the actual distribution of Lucas County based on age, sex, race, and income. Weightings were created for each category within sex (male, female), race/ethnicity (White, Black, Latino, other), Age (8 different age categories), and income (8 different income categories). The numerical value of the weight for each category was calculated by taking the percent of Lucas County within the specific category and dividing that by the percent of the sample within that same specific category. Using sex as an example, the following represents the data from the 2020 Lucas County Survey and the 2018 Census estimates.

2020 Lucas Survey 2018 Census Weight Sex Number Percent Number Percent Male 339 49.41691 209,580 48.47136 0.98087 Female 347 50.58309 222,799 51.52864 1.01869

In this example, it shows that there was a slightly larger portion of males in the sample compared to the actual portion in Lucas County. The weighting for males was calculated by taking the percent of males in Lucas County (based on Census information) (48.47136%) and dividing that by the percent found in the 2020 Lucas County sample (49.41691%) [48.47136 / 49.41691 = weighting of 0.98087 for males]. The same was done for females [51.52864/ 50.58309 = weighting of 1.01869for females]. Thus, males’ responses are weighted less by a factor of 0.98087 and females’ responses weighted less by a factor of 1.01869. This same thing was done for each of the 22 specific categories as described above. For example, a respondent who was female, Black, in the age category 35-44, and with a household income in the $50-$75k category would have an individual weighting of 1.43755 [1.01869 (weight for females) x 1.01336 (weight for Black) x 1.50010 (weight for age 35-44) x 0.92832 (weight for income $50-$75k)]. Thus, each individual in the 2020 Lucas County sample has their own individual weighting based on their combination of age, race/ethnicity, sex, and income. See next page for each specific weighting and the numbers from which they were calculated.


Multiple sets of weightings were created and used in the statistical software package (SPSS 23.0) when calculating frequencies. For analyses done for the entire sample and analyses done based on subgroups other than age, race, sex, or income – the weightings that were calculated based on the product of the four weighting variables (age, race, sex, income) for each individual. When analyses were done comparing groups within one of the four weighting variables (e.g., smoking status by race/ethnicity), that specific variable was not used in the weighting score that was applied in the software package. In the example smoking status by race, the weighting score that was applied during analysis included only age, sex, and income. Thus, a total of eight weighting scores for each individual were created and applied depending on the analysis conducted. The weight categories were as follows:

1. Total weight (product of 4 weights) – for all analyses that did not separate age, race, sex, or income. 2. Weight without sex (product of age, race, and income weights) – used when analyzing by sex. 3. Weight without age (product of sex, race, and income weights) – used when analyzing by age. 4. Weight without race (product of age, sex, and income weights) – used when analyzing by race. 5. Weight without income (product of age, race, and sex weights) – used when analyzing by income. 6. Weight without sex or age (product of race and income weights) – used when analyzing by sex and age. 7. Weight without sex or race (product of age and income weights) – used when analyzing by sex and race. 8. Weight without sex or income (product of age and race weights) – used when analyzing by sex and income.

Category Lucas

Sample %

Lucas 2018 Census*

% Weighting Value

Sex: Male 339 49.41691 209,580 48.47136 0.980866

Female 347 50.58309 222,799 51.52864 1.018693

Age: 20 to 34 years 54 8.05970 89,722 27.92598 3.464891 35 to 44 years 70 10.44776 50,354 15.67269 1.500100 45 to 54 years 115 17.16418 55,349 17.22738 1.003682 55 to 59 years 73 10.89552 31,067 9.66961 0.887485 60 to 64 years 83 12.38806 28,319 8.81429 0.711515 65 to 74 years 163 24.32836 38,444 11.96570 0.491842 75 to 84 years 91 13.58209 18,505 5.75968 0.424065

85+ years 21 3.13433 9,525 2.96466 0.945867

Race: White alone

(non-Hispanic) 384 56.55376 297,943 68.90783 1.218448 African American (NH) 146 21.50221 94,213 21.78945 1.013359

Other (NH) 35 5.15464 40,223 9.30272 1.804727 Hispanic (any race) 114 16.78940 30,210 6.98693 0.416151

Household Income:

Less than $15k 92 14.76726 28,646 15.99754 1.083312 $15k to $25k 86 13.80417 20,692 11.55558 0.837108

$25k to $35k 58 9.30979 20,035 11.18867 1.201818 $35k to $50k 91 14.60674 24,810 13.85530 0.948555 $50k to $75k 112 17.97753 29,884 16.68891 0.928321

$75k to $100k 67 10.75441 19,319 10.78882 1.003199 $100k to $150k 60 9.63082 21,857 12.20618 1.267409 $150k or more 57 9.14928 13,822 7.71898 0.843671

Note: The weighting ratios are calculated by taking the ratio of the proportion of the population of Lucas County in each subcategory by the proportion of the sample in the Lucas County survey for that same category. *Lucas County population figures taken from the 2018 Census Estimates.


The sampling for school districts was a probability sampling method based on enrollments in which larger districts would have a greater number of classes selected to be included in the 2020 Lucas County Youth Health Assessment. Schools were asked to select a general education class or classes for the identified grade level(s) to best represent a cross section of students. Due to variation in the sizes of the classes selected as well as to some districts which sampled additional general education classes, it was determined that applying a weighting during analyses would be important. The reason for this is that it is important that these results are reflective of the collective youth in public schools in Lucas County. To the extent that one district is more or less represented in that mix reflects the possibility that that the results could be skewed towards the students in that district. For example, let’s suppose that one school district had a particularly high level of alcohol use compared to the rest of the districts in Lucas County. If that district had a higher proportion of students in the Lucas County Youth Health Assessment sample compared to their actual proportion in Lucas County, that would result in a higher rate of alcohol use compared to the actual percent among Lucas County public school students as a whole. For this reason, all analyses were conducted with a weighting applied that adjusted for the representation of the number of students in the sample compared to the actual number in the district (from the Ohio Department of Education’s average daily enrollment figures). The table below shows the weightings applied based on the particular district when describing numbers for Lucas County. For example, if the number of students from a given district represented 5% of the sample but that district represented 10% of actual public students in Lucas County, they would have a weighting applied such that their responses would be weighted by 2.0 (0.10000/0.05000). A different district that represented 10% of the sample but only 5% of the actual public students in Lucas County would have a weighting of 0.5 (0.05000/0.10000). Collectively, the application of these weightings helps to ensure that the results best reflect the youth across all responding districts. The table below depicts the weighting applied to each district.

2019 Lucas County Youth 2019 Respondents Weighting # % # % District Maumee 1,540 5.31915% 107 10.35818% 0.51352 Oregon 2,044 7.05996% 138 13.35915% 0.52847 Ottawa Hills 538 1.85825% 102 9.87415% 0.18819 Springfield 2,162 7.46753% 52 5.03388% 1.48345 Sylvania 4,358 15.05250% 256 24.78219% 0.60739 Toledo Public 14,498 50.07599% 291 28.17038% 1.77761 Washington Local 3,812 13.16662% 87 8.42207% 1.56335 28,952 100.00000% 1033 100.00000%

APPENDIX IV: SCHOOL PARTICIPATION | 323

Appendix IV: School Participation The following schools were randomly chosen and participated in the 2019/2020 Lucas County Health Assessment:

Maumee City Gateway Middle School Maumee High School

Oregon City

Fassett Middle School Clay High School

Ottawa Hills Local

Ottawa Hills Middle School Ottawa Hills High School

Springfield Local

Springfield Middle School Springfield High School

Sylvania City

Sylvania Arbor Hills Junior High Sylvania McCord Junior High

Sylvania Timberstone Junior High Sylvania Northview High School Sylvania Southview High School

Toledo Public

Longfellow Elementary McTigue Elementary Robinson Elementary

Ottawa River Elementary Raymer Elementary Beverly Elementary

Bowsher High School Rogers High School Scott High School Start High School Wait High School

Woodward High School

Washington Local Washington Junior High

Jefferson Junior High Whitmer High School

APPENDIX V: LUCAS COUNTY SAMPLE DEMOGRAPHIC PROFILE | 324

Appendix V: Lucas County Sample Demographic Profile*

*The percents reported are the actual percent within each category who responded to the survey. The data contained within the report however are based on weighted data (weighted by age, race, sex, and income). Percents may not add to 100% due to missing data (non-responses) or multiple responses. †The Ohio and Lucas County Census percentages are slightly different than the percent who responded to the survey. Marital status is calculated for those individuals 15 years and older. Education is calculated for those 25 years and older.

Adult Variable 2020 Adult Survey

Sample 2017 Adult Survey

Sample

Lucas County Census

2014-2018 (5-year estimate)

Age

20-29 4.0% 2.0% 14.4% 30-39 8.6% 10.1% 12.2%

40-49 12.8% 15.2% 12.0% 50-59 19.3% 23.8% 13.8% 60 plus 51.3% 48.0% 21.9%

Gender

Male 48.6% 32.1% 48.5% Female 49.7% 67.9% 51.5%

Race/Ethnicity

White 55.0% 50.6% 76.3% Black or African American 20.9% 24.7% 21.8% American Indian or Alaskan Native 2.7% 1.7% 1.1% Asian 0.4% 1.2% 2.4% Other 12.0% 3.0% 3.3% Hispanic Origin (may be of any race) 16.3% 16.1% 7.0%

Marital Status† Married 46.8% 38.5% 42.2% Never been married/member of an unmarried couple 21.5% 19.9%

36.1%

Divorced/Separated 18.9% 24.7% 15.3% Widowed 11.5% 15.5% 6.4%

Education†

Less than High School Diploma 6.9% 11.1% 10.8% High School Diploma 25.9% 30.3% 29.7% Some college/College graduate 65.9% 54.4% 59.5%

Income (Families)

$14,999 and less 13.2% 20.9% 10.7% $15,000 to $24,999 12.3% 13.4% 7.6% $25,000 to $49,999 21.3% 23.6% 22.0% $50,000 to $74,999 16.0% 14.5% 18.2% $75,000 or more 26.4% 18.6% 41.5%

APPENDIX V: LUCAS COUNTY SAMPLE DEMOGRAPHIC PROFILE | 325

Appendix V: Lucas County Youth Sample Demographic Profile*

Youth Variable 2020 Youth Survey Sample

Age

12 years old or younger 20.9% 13 years old 16.1% 14 years’ old 15.2% 15 years’ old 14.2% 16 years’ old 18.2% 17 years’ old 11.5%

18 years old or older 4.0%

Gender

Male 51.3% Female 46.8%

Transgender 0.6% Do not identify as female, male, or transgender 1.4%

Race/Ethnicity

White 65.3% American Indian or Alaskan Native 10.7%

Black or African American 33.7% Hispanic or Latino 16.1%

Asian 4.6% Native Hawaiian or Other Pacific Islander 1.3%

Other 6.1% Arab Ancestry/Ethnic Origin 6.7%

Grade Level

Middle School (6-8) 45.2% High School (9-12) 54.8%

Individual Grade Level

6th grade 11.4% 7th grade 15.2% 8th grade 18.6% 9th grade 9.9%

10th grade 19.5% 11th grade 14.6% 12th grade 10.8%

*Percents may not equal 100% due to missing data (non-responses) or multiple response questions.

APPENDIX VI: DEMOGRAPHICS AND HOUSEHOLD INFORMATION | 326

Appendix VI: Demographics and Household Information

Lucas County Population by Age Groups and Gender U.S. Census 2010

Age Total Males Females

Lucas County 37,642 18,679 18,963

0-4 years 29,732 15,052 14,680 1-4 years 23,928 12,130 11,798 < 1 year 5,804 2,922 2,882 1-2 years 12,017 6,072 5,853 3-4 years 11,911 6,058 5,853 5-9 years 28,756 14,772 13,984 5-6 years 11,648 6,034 5,614 7-9 years 17,108 8,738 8,370

10-14 years 28,629 14,625 14,004 10-12 years 17,259 8,903 8,356 13-14 years 11,370 5,722 5,648 12-18 years 43,198 22,027 21,171 15-19 years 33,647 17,137 16,510 15-17 years 16,320 9,750 9,270 18-19 years 14,627 7,387 7,240 20-24 years 33,821 16,792 17,029 25-29 years 29,411 14,536 14,875 30-34 years 26,532 13,032 13,500 35-39 years 27,604 13,492 14,112 40-44 years 27,046 13,209 13,837 45-49 years 31,196 15,064 16,132 50-54 years 33,245 16,157 17,088 55-59 years 29,749 14,411 15,338 60-64 years 24,638 11,918 12,720 65-69 years 16,696 7,676 9,020 70-74 years 12,727 5,622 7,105 75-79 years 10,456 4,244 6,212 80-84 years 9,333 3,572 5,761 85-89 years 5,776 1,919 3,857 90-94 years 2,267 632 1,635 95-99 years 494 94 400

100-104 years 56 9 47 105-109 years 2 0 2

110 years & over 2 1 1 Total 85 years and over 8,597 2,655 5,942 Total 65 years and over 57,809 23,769 34,040 Total 19 years and over 328,715 156,239 172,476


LUCAS COUNTY PROFILE (Source: U.S. Census Bureau, 2019)

2019 ACS 1-year estimates

General Demographic Characteristics

Number Percent (%)

Total Population 2019 Total Population 428,348 100% Largest City – City of Toledo 2019 Total Population 272,778 100% Population by Race/Ethnicity Total population 428,348 100% White 309,082 72.2% Black or African American 81,931 19.1% American Indian or Alaskan Native 1,270 0.3% Native Hawaiian/Other Pacific Islander 630 0.1% Asian 7,376 1.7% Other 7,692 1.8% Two or more races 20,367 4.8% Hispanic or Latino (of any race) 31,604 7.4% Population by Age Under 5 years 27,099 6.3% 5 to 14 years 54,847 12.8% 15 to 24 years 52,900 12.4% 25 to 44 years 111,497 26.0% 45 to 64 years 110,620 25.8% 65 years and more 71,385 16.7% Median age (years) 38.0 N/A Household by Type Total households 182,105 100% Households with children <18 years 49,828 27.4% Married-couple family household 71,079 39.0% Married-couple family household with children <18 years 23,263 12.8% Female householder, no husband present 58,875 32.3% Female householder, no husband present, with children <18 years 14,124 7.8% Nonfamily household (single person) living alone 30,776 16.9% Nonfamily household (single person) 65 years and over 14,460 7.9% Average household size 2.30 people N/A Average family size 2.92 people N/A


General Demographic Characteristics, Continued

Housing Occupancy Median value of owner-occupied units $124,200 N/A Median housing units with a mortgage $1,205 N/A Median housing units without a mortgage $479 N/A Median value of occupied units paying rent $757 N/A Median rooms per total housing unit 5.9 N/A Total occupied housing units 182,105 100% No telephone service available 1,879 1.0% Lacking complete kitchen facilities 1,739 1.0% Lacking complete plumbing facilities 676 0.4% Total household with a computer 166,919 91.7% Total households with a broadband internet subscription 154,447 84.8%

Selected Social Characteristics

School Enrollment Population 3 years and over enrolled in school 101,218 100% Nursery & preschool 6,210 6.1% Kindergarten 5,112 5.1% Elementary School (Grades 1-8) 43,330 42.8% High School (Grades 9-12) 20,639 20.4% College or Graduate School 25,927 25.6% Educational Attainment Population 25 years and over 293,502 100% < 9th grade education 8,351 2.8% 9th to 12th grade, no diploma 23,733 8.1% High school graduate (includes equivalency) 85,364 29.1% Some college, no degree 67,125 22.9% Associate degree 29,911 10.2% Bachelor’s degree 49,217 16.8% Graduate or professional degree 29,801 10.2% Percent high school graduate or higher N/A 89.1% Percent Bachelor’s degree or higher N/A 26.9% Marital Status Population 15 years and over 346,402 100% Never married 125,619 36.3% Now married, excluding separated 148,098 42.7% Separated 6,424 1.9% Widowed 22,643 6.5% Widowed females 17,262 5.0% Divorced 43,618 12.6% Divorced females 26,353 7.6% Veteran Status Civilian population 18 years and over 330,079 100% Veterans 18 years and over 20,033 6.1%


Selected Economic Characteristics Employment Status Population 16 years and over 341,129 100.0% 16 years and over in labor force 213,175 62.5% 16 years and over not in labor force 127,954 37.5% Females 16 years and over 178,186 -- Females 16 years and over in labor force 103,628 58.2% Population living with own children <6 years 31,761 -- All parents in family in labor force 21,575 67.9% Population living with own children 6 to 17 years 59,420 -- All parents in family in labor force 43,830 73.8% Class of Worker Civilian employed population 16 years and over 197,998 100.0% Private for-profit wage and salary workers 144,358 72.9% Private not-for-profit wage and salary workers 22,784 11.5% Local government workers 13,725 6.9% State government workers 6,030 3.0% Federal government workers 2,859 1.4% Self-employed in own not incorporated business workers and unpaid family workers

8,242 4.2%

Occupations Civilian employed population 16 years and over 197,998 100% Management, business, science, and arts occupations 67,774 34.2% Service occupations 35,600 18.0% Sales and office occupations 41,838 21.1% Natural resources, construction, and maintenance occupations 14,583 7.4% Production, transportation, and material moving occupations 38,203 19.3% Leading Industries Civilian employed population 16 years and over 197,998 100.0% Agriculture, forestry, fishing and hunting, and mining 786 0.4% Construction 11,001 5.6% Manufacturing 34,875 17.6% Wholesale trade 5,946 3.0% Retail trade 24,676 12.5% Transportation and warehousing, and utilities 11,153 5.6% Information 2,751 1.4% Finance and insurance, and real estate and rental and leasing 9,183 4.6% Professional, scientific, and management, and administrative and waste management services 19,334 9.8%

Educational services, and health care and social assistance 46,554 23.5% Arts, entertainment, and recreation, and accommodation and food services

18,437 9.3%

Other services, except public administration 7,339 3.7% Public administration 5,963 3.0%


Selected Economic Characteristics, Continued

Bureau of Economic Analysis (BEA) Per Capita Personal Income (PCPI) Figures

Income Rank of Ohio Counties BEA Per Capita Personal Income 2018 $ 46,290 23th of 88 counties BEA Per Capita Personal Income 2017 $ 44,230 26th of 88 counties BEA Per Capita Personal Income 2016 $ 43,390 21th of 88 counties BEA Per Capita Personal Income 2015 $ 42,609 20th of 88 counties BEA Per Capita Personal Income 2014 $ 40,811 23th of 88 counties

(Source: Bureau of Economic Analysis, https://apps.bea.gov/iTable/index_regional.cfm) Note: BEA PCPI figures are greater than Census figures for comparable years due to deductions for retirement, Medicaid, Medicare payments, and the value of food stamps, among other things

Income In 2019 Total households 182,105 100.0% Less than $10,000 18,939 10.4% $10,000 to $14,999 8,377 4.6% $15,000 to $24,999 20,032 11.0% $25,000 to $34,999 21,124 11.6% $35,000 to $49,999 23,674 13.0% $50,000 to $74,999 30,594 16.8% $75,000 to $99,999 20,396 11.2% $100,000 to $149,999 22,581 12.4% $150,000 to $199,999 9,287 5.1% $200,000 or more 6,920 3.8% Median household income (dollars) $49,448 N/A Income in 2019 Families 107,737 100.0% Less than $10,000 7,326 6.80% $10,000 to $14,999 2,478 2.30% $15,000 to $24,999 10,020 9.30% $25,000 to $34,999 9,265 8.60% $35,000 to $49,999 12,390 11.50% $50,000 to $74,999 18,962 17.60% $75,000 to $99,999 15,083 14.00% $100,000 to $149,999 17,992 16.70% $150,000 to $199,999 7,973 7.40% $200,000 or more 6,141 5.70% Median family income (dollars) $65,250 N/A Per capita income (dollars) $29,871 N/A Poverty Status in 2019 People in families N/A 13.1% Unrelated individuals 15 years and over N/A 29.7%


Poverty Rates, 5-year averages 2013 to 2017

(Source: The Ohio Poverty Report, Ohio Development Services Agency, February 2019, http://www.development.ohio.gov/files/research/P7005.pdf)

Employment Statistics, as of August 2020

*Rate equals unemployment divided by labor force. (Source: Ohio Department of Job and Family Services, August 2020, https://ohiolmi.com/Home/RateMapArchive)

Category Lucas Ohio

Population in poverty 19.8% 14.9%

< 125% FPL (%) 24.9% 19.3%

< 150% FPL (%) 29.7% 23.6%

< 200% FPL (%) 39.0% 32.5%

Population in poverty (2002) 12.2% 10.2%

Category Lucas Ohio

Labor Force 211,500 5,786,900

Employed 189,300 5,276,700

Unemployed 22,200 510,200

Unemployment Rate* in August 2020 10.5 8.8

Unemployment Rate* in July 2020 10.6 9.1

Unemployment Rate* in August 2019 4.7 4.2


Estimated Poverty Status in 2018

Age Groups Number 90% Lower Confidence

Interval

90% Upper Confidence

Interval Percent

90% Lower Confidence

Interval

90% Upper Confidence

Interval Lucas County All ages in poverty 78,398 72,899 83,897 18.7% 17.4% 20.0% Ages 0-17 in poverty 24,153 20,819 27,487 25.0% 21.6% 28.4% Ages 5-17 in families in poverty

16,302 13,694 18,910 23.4% 19.7% 27.1%

Median household income

$47,865 $45,854 $49,876

Ohio All ages in poverty 1,568,586 1,542,309 1,594,863 13.8% 13.6% 14.0% Ages 0-17 in poverty 489,053 474,343 503,763 19.2% 18.6% 19.8% Ages 5-17 in families in poverty

329,764 317,103 342,425 17.8% 17.1% 18.5%


$56,155 $55,735 $56,575

United States All ages in poverty 41,852,315 41,619,366 42,085,264 13.1% 13.0% 13.2% Ages 0-17 in poverty 12,997,532 12,873,127 13,121,937 18.0% 17.8% 18.2% Ages 5-17 in families in poverty

8,930,152 8,834,521 9,025,783 17.0% 16.8% 17.2%


$61,937 $61,843 $62,031

(Source: U.S. Census Bureau, 2018 Poverty and Median Income Estimates, https://www.census.gov/data/datasets/2018/demo/saipe/2018-state-and-county.html)

Federal Poverty Thresholds in 2019 by Size of Family and Number of Related Children Under 18 Years of Age

Size of Family Unit No

Children One

Child Two

Children Three

Children Four

Children Five

Children 1 Person <65 years $13,300

1 Person 65 and > $12,261 2 people

Householder < 65 years $17,120 $17,622

2 People Householder 65 and >

$15,453 $17,555

3 People $19,998 $20,578 $20,598 4 People $26,370 $26,801 $25,926 $26,017 5 People $31,800 $32,263 $31,275 $30,510 $30,044 6 People $36,576 $36,721 $35,965 $35,239 $34,161 $33,522 7 People $42,085 $42,348 $41,442 $40,811 $39,635 $38,262 8 People $47,069 $47,485 $46,630 $45,881 $44,818 $43,470

9 People or > $56,621 $56,895 $56,139 $55,503 $54,460 $53,025 (Source: U. S. Census Bureau, Poverty Thresholds 2019, https://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-thresholds.html)

APPENDIX VII: COUNTY HEALTH RANKINGS | 333

Appendix VII: County Health Rankings

(Source: 2020 County Health Rankings for Lucas County, Ohio and U.S. data)

Lucas

County 2020

Ohio 2020

U.S. 2020

Health Outcomes Premature death. Years of potential life lost before age 75 per 100,000 population (age-adjusted) (2065-2018)

9,800 8,600 6,900

Overall heath. Percentage of adults reporting fair or poor health (age-adjusted) (2017)

19% 18% 17%

Physical health. Average number of physically unhealthy days reported in past 30 days (age-adjusted) (2017)

4.3 3.9 3.8

Mental health. Average number of mentally unhealthy days reported in past 30 days (age-adjusted) (2017)

4.5 4.6 4.0

Maternal and infant health. Percentage of live births with low birthweight (< 2500 grams) (2012-2018)

10% 9% 8%

Health Behaviors Tobacco. Percentage of adults who are current smokers (2017)

21% 21% 17%

Obesity. Percentage of adults that report a BMI of 30 or more (2015)

35% 32% 29%

Food environment. Index of factors that contribute to a healthy food environment, 0 (worst) to 10 (best) (2015-2016)

6.7 6.9 7.6

Physical inactivity. Percentage of adults aged 20 and over reporting no leisure-time physical activity (2015)

27% 26% 23%

Active living environment. Percentage of population with adequate access to locations for physical activity (2010 & 2018)

98% 84% 84%

Excessive drinking. Percentage of adults reporting binge or heavy drinking (2017)

20% 20% 19%

Drug and alcohol abuse and injury. Percentage of driving deaths with alcohol involvement (2014-2018)

40% 33% 28%

Infectious disease. Number of newly diagnosed chlamydia cases per 100,000 population (2017)

766.6 526.6 524.6

Sexual and reproductive health. Teen birth rate per 1,000 female population, ages 15-19 (2012-2018)

32 24 23


(Source: 2020 County Health Rankings for Lucas County, Ohio and U.S. data)

Lucas

County 2020

Ohio 2020

U.S. 2020

Clinical Care Coverage and affordability. Percentage of population under age 65 without health insurance (2017)

8% 7% 10%

Access to health care/medical care. Ratio of population to primary care physicians (2017)

1,090:1 1,310:1 1,330:1

Access to dental care. Ratio of population to dentists (2017)

1,360:1 1,610:1 1,450:1

Access to behavioral health care. Ratio of population to mental health providers (2018)

340:1 410:1 400:1

Hospital utilization. Number of hospital stays for ambulatory-care sensitive conditions per 1,000 Medicare enrollees (2019)

6,143 5,168 4,535

Mammography screening. Percentage of female Medicare enrollees ages 67-69 that receive mammography screening (2017)

42% 43% 42%

Flu vaccinations. Percentage of Medicare enrollees that had an annual flu vaccination (2017)

50% 49% 46%

Social and Economic Factors

Education. Percentage of ninth-grade cohort that graduates in four years (2017-2018)

84% 85% 85%

Education. Percentage of adults ages 25-44 years with some post-secondary education (2014-2018)

66% 65% 66%

Employment, poverty, and income. Percentage of population ages 16 and older unemployed but seeking work (2018)

5.3% 4.6% 3.9%

Employment, poverty, and income. Percentage of children under age 18 in poverty (2018)

25% 19% 18%

Employment, poverty, and income. Ratio of household income at the 80th percentile to income at the 20th percentile (2014-2018)

5.4 4.7 4.9

Family and social support. Percentage of children that live in a household headed by single parent (2014-2018)

48% 36% 33%

Family and social support. Number of membership associations per 10,000 population (2017)

9.9 11.2 9.3

Violence. Number of reported violent crime offenses per 100,000 population (2014 & 2016)

824 293 386

Injury. Number of deaths due to injury per 100,000 population (2014-2018)

91 87 70


(Source: 2020 County Health Rankings for Lucas County, Ohio and U.S. data) N/A – Not Available

Lucas

County 2020

Ohio 2020

U.S. 2020

Physical Environment Air, water, and toxic substances. Average daily density of fine particulate matter in micrograms per cubic meter (PM2.5) (2014)

11.9 11.5 8.6

Air, water, and toxic substances. Indicator of the presence of health-related drinking water violations. Yes - indicates the presence of a violation, No - indicates no violation (2018)

Yes N/A N/A

Housing. Percentage of households with at least 1 of 4 housing problems: overcrowding, high housing costs, or lack of kitchen or plumbing facilities (2012-2016)

16% 14% 18%

Transportation. Percentage of the workforce that drives alone to work (2014-2018)

84% 83% 76%

Transportation. Among workers who commute in their car alone, the percentage that commute more than 30 minutes (2014-2018)

20% 30% 36%

FOREWORD | 1 · 2017. 9. 12. · FOREWORD | 1 Executive Committee • Adelante • Advocates for...

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